Document Detail


Gaseous emboli during off-pump surgery with T-graft technique, two different mechanisms.
MedLine Citation:
PMID:  20154069     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Akmal M A Badreldin; Alexander A Albert; Mohamed M Ismail; Matthias Heldwein; Fabian Doerr; Torsten Bossert; Artur Lichtenberg; Khosro Hekmat
Related Documents :
18522699 - Osteomyelitis of the rib caused by aspergillus flavus following cardiac surgery.
19029269 - Clinical impact and biomaterial evaluation of autologous platelet gel in cardiac surgery.
12463619 - The hybrid approach to coronary artery revascularization: minimally invasive direct cor...
7819629 - Long-term survival after coronary artery bypass grafting.
7457039 - Advantages and disadvantages of the use of double-lumen tubes in pulmonary surgery.
10617009 - Economic outcome of off-pump coronary artery bypass surgery: a prospective randomized s...
7131009 - Ruptured intracranial aneurysms: has the incidence of early rebleeding been over-estima...
11382719 - Detection of coronary artery stenoses by contrast-enhanced, retrospectively electrocard...
19418349 - Three-dimensional reconstruction of the uterine vascular supply through vascular castin...
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-02-12
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  10     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-20     Completed Date:  2010-08-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  766-9     Citation Subset:  IM    
Copyright Information:
2010 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.
Affiliation:
Department of Cardio-Thoracic-Surgery, Friedrich Schiller University of Jena, Jena, Germany. akmalbadreldin@yahoo.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
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:
124-38-9/Carbon Dioxide
Comments/Corrections
Comment In:
Interact Cardiovasc Thorac Surg. 2010 May;10(5):769-70; discussion 770   [PMID:  20403986 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Association of HLA-A, -B and -DRB1 genotype with birth-weight and CD34+ cell content; analysis of Ko...
Next Document:  Cardiac myxoma mimicking extension of renal cell carcinoma.