Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Feb 2006
Perioperative outcome in adults undergoing elective deep hypothermic circulatory arrest with retrograde cerebral perfusion in proximal aortic arch repair: evaluation of protocol-based care.
The purpose of this study was to describe perioperative outcome in adults undergoing elective proximal aortic arch repair with protocol-based deep hypothermic circulatory arrest (DHCA) with retrograde cerebral perfusion (RCP). ⋯ The above parameters establish a baseline incidence for major perioperative complications in adults undergoing elective DHCA with RCP for elective proximal aortic arch repair. In approaching the open aortic arch for short periods of circulatory arrest, deep hypothermia with adjunctive RCP is safe and effective.
-
J. Cardiothorac. Vasc. Anesth. · Feb 2006
Detection and monitoring of complications associated with femoral or axillary arterial cannulation for surgical repair of aortic dissection.
Femoral arterial perfusion can be associated with complications, and axillary arterial perfusion is not free from risk. The purpose of this study was to describe the incidence and complications of femoral versus axillary artery cannulation for surgical repair of aortic dissection and to devise a strategy for early detection and monitoring of complications using transesophageal echocardiography, near-infrared spectroscopy, and orbital Doppler. ⋯ Flexible management guided by real-time information is essential. Upon initiating femoral arterial perfusion, malperfusion should first be checked for in the descending aorta and then in the coronary and visceral arteries, especially in cases of type III dissection with retrograde extension. Attention should be paid to cerebral and coronary malperfusion when initiating axillary arterial perfusion.
-
J. Cardiothorac. Vasc. Anesth. · Feb 2006
Serum lactate level has prognostic significance after pediatric cardiac surgery.
The determination of postoperative course after cardiac surgery has always been a challenging issue. It is more sophisticated in the pediatric age group. The aim of this investigation was to identify whether increased concentrations of lactate in arterial blood has a predictive value for postoperative morbidity and mortality after heart surgery. ⋯ Blood lactate concentration of 4.8 mmol/L or higher during the early postoperative hours identifies a group of patients with increased risk of postoperative morbidity and mortality.