| Gaseous emboli during off-pump surgery with T-graft technique, two different mechanisms. | |
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MedLine Citation:
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PMID: 20154069 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Gaseous embolism is a possible complication during off-pump coronary surgery with the use of a blower and can cause ischemic injuries. We describe two different possible mechanisms of carbon-dioxide embolization. METHODS: Out of 2196 coronary bypass surgeries, between 1 January 2007 and 31 December 2009, there were 977 off-pump operations. Two off-pump cases (0.2%) had gaseous (carbon-dioxide) emboli that migrated against blood stream proximally through T-anastomoses and then into the native coronary vessels. These emboli caused a temporary haemodynamic deterioration in other territories. Two types of T-anastomoses were included [saphenous vein on left internal thoracic artery (LITA) or right internal thoracic artery (RITA) on LITA]. RESULTS: Simple procedures and measurements were necessary but enough to regain haemodynamic stability. There was no effect on the postoperative outcome. CONCLUSION: We have concluded that carbon-dioxide emboli can also cause massive but temporary haemodynamic deterioration during off-pump surgery despite higher solubility in blood. The blower should be used only when a bull-dog clamp is applied on the graft. Also, proper de-airing and flushing of grafts is very important and avoids consequences of the trapped small emboli. |
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Authors:
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Akmal M A Badreldin; Alexander A Albert; Mohamed M Ismail; Matthias Heldwein; Fabian Doerr; Torsten Bossert; Artur Lichtenberg; Khosro Hekmat |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2010-02-12 |
Journal Detail:
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Title: Interactive cardiovascular and thoracic surgery Volume: 10 ISSN: 1569-9285 ISO Abbreviation: Interact Cardiovasc Thorac Surg Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-04-20 Completed Date: 2010-08-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101158399 Medline TA: Interact Cardiovasc Thorac Surg Country: England |
Other Details:
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Languages: eng Pagination: 766-9 Citation Subset: IM |
Copyright Information:
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2010 Published by European Association for Cardio-Thoracic Surgery. All rights reserved. |
Affiliation:
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Department of Cardio-Thoracic-Surgery, Friedrich Schiller University of Jena, Jena, Germany. akmalbadreldin@yahoo.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Anastomosis, Surgical / adverse effects, methods Carbon Dioxide / adverse effects, pharmacology Coronary Artery Bypass / adverse effects, methods Coronary Artery Bypass, Off-Pump / adverse effects*, methods Coronary Disease / radiography, surgery* Embolism, Air / radiography*, surgery Female Follow-Up Studies Graft Rejection Graft Survival Hemodynamics / physiology Humans Insufflation / adverse effects Intraoperative Complications / diagnosis*, surgery Male Middle Aged Risk Assessment Survival Rate Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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124-38-9/Carbon Dioxide |
| Comments/Corrections | |
Comment In:
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Interact Cardiovasc Thorac Surg. 2010 May;10(5):769-70; discussion 770
[PMID:
20403986
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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