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Continuous cerebral and myocardial selective perfusion in neonatal aortic arch surgery
ConclusionCCMSP is a safe and reproducible strategy for cerebral, myocardial and visceral protection in neonatal aortic arch repair, with or without VSD closure, resulting in low complication and mortality.
Source: Journal of Cardiac Surgery - October 21, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Pierre Maminirina, Carine Pavy, Pierre Bourgoin, Olivier Baron Tags: ORIGINAL ARTICLE Source Type: research

Mechanisms of Stroke in Patients with Chronic Kidney Disease.
Abstract BACKGROUND: Given the increasing worldwide prevalence of chronic kidney disease (CKD), it is critical to decrease the associated risk of debilitating vascular complications, including stroke, congestive heart failure, myocardial infarction, and peripheral vascular disease. Treatment options for reducing the risk of all subtypes of stroke in patients with CKD remain limited. For patients with end-stage kidney disease (ESKD), novel applications of noninvasive imaging may help personalize the type of dialysis and dialysis prescription for patients at high-risk. SUMMARY: This manuscript reviews the heigh...
Source: American Journal of Nephrology - August 27, 2019 Category: Urology & Nephrology Authors: Ghoshal S, Freedman BI Tags: Am J Nephrol Source Type: research

Hemiarch Reconstruction Versus Clamped Aortic Anastomosis for Concomitant Ascending Aortic Aneurysm
ConclusionsHemiarch replacement using DHCA with RCP does not increase the risk of operative complications compared with a normothermic, clamped-distal aortic anastomosis, and therefore its use should not be limited when planning complex multiprocedural reconstructions during elective ascending thoracic aortic replacement with concomitant cardiac surgery.
Source: The Annals of Thoracic Surgery - August 21, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Asymptomatic Cerebrovascular Disease in Dialysis Patients.
Authors: Naganuma T, Takemoto Y Abstract Cerebrovascular disease is a major cause of death in dialysis patients, who have a much higher incidence of stroke compared to the normal population. Recent studies have shown that asymptomatic cerebral small-vessel disease, including silent brain infarction (SBI), white matter hyperintensities (WMHs), and cerebral microbleeds (CMBs), is related to the future onset of stroke. Cerebral small-vessel disease is caused by microvascular damage to the small penetrating arteries of the middle cerebral artery including arteriolosclerosis, fibrinoid necrosis, and lipohyalinosis attri...
Source: Contributions to Nephrology - July 26, 2018 Category: Urology & Nephrology Tags: Contrib Nephrol Source Type: research

Blood cardioplegia benefits only patients with a long cross-clamp time.
CONCLUSIONS: We did not find clear evidence of superiority of either type in the uncomplicated patient. When prolonged cross-clamp time or postoperative ventilation is expected, this study indicates that blood cardioplegia might be preferable. PMID: 30044166 [PubMed - as supplied by publisher]
Source: Perfusion - July 25, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Fedosova M, Kimose HH, Greisen JR, Fast P, Gissel MS, Jakobsen CJ Tags: Perfusion Source Type: research

Hemiarch Reconstruction Vs Clamped Aortic Anastomosis for Concomitant Ascending Aortic Aneurysm
Conclusions Hemiarch replacement using DHCA with RCP does not increase the risk of operative complications compared to a normothermic, clamped-distal aortic anastomosis, and therefore its use should not be limited when planning complex multi-procedural reconstructions during elective ascending thoracic aortic replacement with concomitant cardiac surgery.
Source: The Annals of Thoracic Surgery - May 4, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Hemiarch Reconstruction Vs Clamped Aortic Anastomosis for Concomitant Ascending Aortic Aneurysm.
CONCLUSIONS: Hemiarch replacement using DHCA with RCP does not increase the risk of operative complications compared to a normothermic, clamped-distal aortic anastomosis, and therefore its use should not be limited when planning complex multi-procedural reconstructions during elective ascending thoracic aortic replacement with concomitant cardiac surgery. PMID: 29730345 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - May 3, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Sultan I, Bianco V, Yajzi I, Kilic A, Dufendach K, Cardounel A, Althouse AD, Masri A, Navid F, Gleason TG Tags: Ann Thorac Surg Source Type: research

Intradialytic Cardiac Magnetic Resonance Imaging to Assess Cardiovascular Responses in a Short-Term Trial of Hemodiafiltration and Hemodialysis
In conclusion, in this randomized, crossover study, there was no significant difference in the cardiovascular response to HDF or HD with cooled dialysate as assessed with intradialytic MRI.
Source: Journal of the American Society of Nephrology : JASN - March 31, 2017 Category: Urology & Nephrology Authors: Buchanan, C., Mohammed, A., Cox, E., Köhler, K., Canaud, B., Taal, M. W., Selby, N. M., Francis, S., McIntyre, C. W. Tags: Clinical Research Source Type: research

Total aortic arch repair: risk factor analysis and follow-up in 199 patients AORTIC SURGERY
CONCLUSIONS Aortic arch repair remains a high-risk procedure, especially in multisegment aortic disease. Several peri- and postoperative factors predicted adverse outcome, indicating the need to further improve perioperative management (e.g. organ protection). Indications for FET treatment have to be thoroughly investigated (e.g. FET in CDs).
Source: European Journal of Cardio-Thoracic Surgery - November 3, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Martens, A., Beckmann, E., Kaufeld, T., Umminger, J., Fleissner, F., Koigeldiyev, N., Krueger, H., Puntigam, J., Haverich, A., Shrestha, M. Tags: Extracorporeal circulation, Vascular malformations AORTIC SURGERY Source Type: research

Is moderate hypothermic circulatory arrest with selective antegrade cerebral perfusion superior to deep hypothermic circulatory arrest in elective aortic arch surgery?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether moderate hypothermia circulatory arrest with selective antegrade cerebral perfusion (SACP) is more beneficial than deep hypothermic circulatory arrest in elective aortic arch surgery. Altogether, 1028 papers were found using the reported search, of which 6 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. There were four retrospective obser...
Source: Interactive CardioVascular and Thoracic Surgery - August 21, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Poon, S. S., Estrera, A., Oo, A., Field, M. Tags: Extracorporeal circulation Adult Cardiac Source Type: research

Extra-anatomic revascularization for preoperative cerebral malperfusion due to distal carotid artery occlusion in acute type A aortic dissection AORTIC SURGERY
CONCLUSION Extra-anatomic bypass for LCCA or RCCA occlusion allows for early selective cerebral perfusion during AADA repair, and may reduce the risk of neurological complications in patients with preoperative cerebral malperfusion.
Source: European Journal of Cardio-Thoracic Surgery - January 13, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Luehr, M., Etz, C. D., Nozdrzykowski, M., Lehmkuhl, L., Misfeld, M., Bakhtiary, F., Borger, M. A., Mohr, F.-W. Tags: Great vessels AORTIC SURGERY Source Type: research

Moderate Versus Deep Hypothermia With Unilateral Selective Antegrade Cerebral Perfusion for Acute Type A Dissection
Conclusions Moderate HCA with uSACP is an effective circulation management strategy that provides excellent cerebral and visceral protection during emergent ATAAD repair. In the setting of antegrade cerebral perfusion, deep hypothermia does not provide any additional benefit.
Source: The Annals of Thoracic Surgery - October 30, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Multi‐modal CT in acute stroke: wait for a serum creatinine before giving intravenous contrast? No!
ConclusionsThe incidence of CIN is low when MMCT is used routinely to assess acute stroke patients. In this population, CIN was a biochemical phenomenon that did not have clinical manifestations, cause chronic kidney disease, require dialysis, or negatively impact on 90‐day mRS outcomes. Renal profiling and waiting for a baseline serum‐creatinine are an unnecessary delay to emergency reperfusion treatment.
Source: International Journal of Stroke - August 26, 2015 Category: Neurology Authors: Timothy E. Ang, Andrew Bivard, Christopher Levi, Henry Ma, Chung Y. Hsu, Bruce Campbell, Geoffrey Donnan, Stephen M. Davis, Mark Parsons Tags: Research Source Type: research

Is Total Arch Replacement Associated With Worse Outcomes During Repair of Acute Type A Aortic Dissection?
Conclusions Acute type A aortic dissection remains a challenge associated with significant mortality and morbidity. When compared with a less aggressive resection, total arch replacement performed in an individualized fashion can be associated with acceptable early and late outcomes for ATAAD and was not associated with worse outcomes.
Source: The Annals of Thoracic Surgery - August 11, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

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