| Retrograde cerebral perfusion as an adjunct to prolonged hypothermic circulatory arrest. | |
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MedLine Citation:
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PMID: 10531148 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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STUDY OBJECTIVE: This study was designed to evaluate the use of retrograde cerebral perfusion (RCP) combined with deep hypothermic circulatory arrest (DHCA) in the treatment of complex congenital and adult cardiac disease. DESIGN: Retrospective chart review of 52 cardiac surgery patients (34 male and 18 female; age range, 3 weeks to 89 years old; mean age, 60 years old) who received RCP in conjunction with DHCA from July 1991 through August 1998. RESULTS: Surgical procedures consisted of the following: (1) repair of ascending aortic aneurysms (n = 16); (2) repair of type A aortic dissection (n = 16); (3) repair of arch aneurysms (n = 10); (4) renal cell carcinoma with tumor extension to the inferior vena cava (IVC) and right atrium (n = 5); (6) coronary artery bypass grafting and concomitant aortic valve replacement with calcified aorta (n = 2); (7) Norwood procedure and take down of a Pott's shunt (n = 2); and (8) massive air embolism treatment (n = 1). Mean RCP time was 39 min (range, 3 to 88 min). Thirteen patients had RCP times > 60 min. Mean core temperature (rectal or bladder) was 19 degrees C (range, 15 degrees to 28 degrees C). There were six early deaths, four of which were related to persistent low-output cardiac failure, and two resulted from perioperative stroke. All remaining patients recovered fully without neurologic deficits. CONCLUSION: RCP is a reliable and technically appealing tool that does the following: (1) it improves DHCA safety and is applicable in a variety of clinical settings with relative ease; (2) it potentially provides oxygen and nutritional support to the brain during DHCA; (3) it helps remove air and other debris from the cerebral vessels; and (4) it is useful in dealing with congenital heart disease and tumor extension into the IVC. |
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Authors:
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F Esmailian; H Dox; A Sadeghi; K Eghbali; H Laks |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Chest Volume: 116 ISSN: 0012-3692 ISO Abbreviation: Chest Publication Date: 1999 Oct |
Date Detail:
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Created Date: 1999-11-08 Completed Date: 1999-11-08 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0231335 Medline TA: Chest Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 887-91 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgery, University of California at Los Angeles Medical Center, Los Angeles, CA 90095-1741, USA. fesmaili@surgery.medsch.ucla.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Brain / blood supply* Cardiac Surgical Procedures* Cause of Death Female Heart Arrest, Induced / methods* Heart Defects, Congenital / mortality, physiopathology, surgery* Heart Diseases / mortality, physiopathology, surgery* Hospital Mortality Humans Hypothermia, Induced Infant, Newborn Male Middle Aged Perfusion Postoperative Complications / mortality, physiopathology Stroke / mortality, physiopathology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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