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Perioperative Management of Deep Hypothermic Circulatory .

hypothermic circulatory arrest (DHCA), covering major is-sues including pathophysiology of ischemic injury, organ protec-tion (both pharmacologic and nonpharmacologic), temperature control, and perfusion methods. The purpose of this review is to serve as a resource for board review or as introductory material for a cardiac anesthesia rotation.

Circulatory arrest - definition of Circulatory arrest by .

Circulatory arrest synonyms, Circulatory arrest pronunciation, Circulatory arrest translation, English dictionary definition of Circulatory arrest. n. 1. Sudden cessation of heartbeat and cardiac function, resulting in the loss of effective circulation. . cardiac arrest - absence of systole; failure of the ventricles of the heart to contract .

Aortic arch replacement without circulatory arrest or deep .

Although current developments in aortic arch replacement have demonstrated progressively improving mortality, cerebral morbidity remains significant. We describe a "branch-first" technique that avoids circulatory arrest and profound hypothermia, yielding excellent survival and low cerebral morbidity.

Pharmacological agents as cerebral protectants during deep .

FORUM Pharmacological agents as cerebral protectants during deep hypothermic circulatory arrest in adult thoracic aortic surgery A survey of current practice* A. T. Dewhurst,1 S. J. Moore1 and J. B. Liban2 1 Specialist Registrar and 2 Consultant, Department of .

Optimal temperature management in aortic arch operations .

Aug 08, 2016 · Hypothermic circulatory arrest is a critical component of aortic arch procedures, without which these operations could not be safely performed. Despite the use of hypothermia as a protective adjunct for organ preservation, aortic arch surgery remains complex and is associated with numerous complications despite years of surgical advancement.

Varying Evidence on Deep Hypothermic Circulatory Arrest in .

Cardiovascular surgeons have long debated the safe duration of deep hypothermic circulatory arrest during thoracic aortic aneurysm surgery. The rationale for using adjunctive cerebral perfusion (or not) is to achieve the best technical aortic repair with the lowest risk of morbidity and death. In this literature review, we highlight the debates .

Optimal temperature management in aortic arch operations .

Aug 08, 2016 · Hypothermic circulatory arrest is a critical component of aortic arch procedures, without which these operations could not be safely performed. Despite the use of hypothermia as a protective adjunct for organ preservation, aortic arch surgery remains complex and is associated with numerous complications despite years of surgical advancement.

UpToDate

Jun 18, 2020 · Deep hypothermic circulatory arrest (DHCA) permits surgical reconstruction of the aortic arch without crossclamping a diseased aorta or instrumenting and possibly injuring aortic arch branch vessels. Selective antegrade cerebral perfusion (SACP) is a technique to perfuse the brain using the CPB circuit by direct cannulation of the axillary .

Deep Hypothermic Circulatory Arrest | Cardiac Surgery in .

HCA traces its beginnings to the work of Bigelow who demonstrated a role for hypothermia in cardiac surgery in a canine model. 2 John Lewis used systemic hypothermia at 28°C combined with venous inflow occlusion to perform the first successful atrial septal defect repair. He subsequently described the use of profound systemic hypothermia (9°C) with one hour of circulatory arrest without any .

Ascending and Arch Aorta | Circulation

The popularization of deep hypothermic circulatory arrest (HCA) as an adjunctive technique to allow a "safe" period of cerebral ischemia by Griepp and colleagues revolutionized aortic arch repair. 41 The premise of this approach relies on the observed reduction of metabolism noted with deep hypothermia (15 to 18°C), which in turn affords a .

Deep hypothermic circulatory arrest (Chapter 10 .

Khaladj, N, Shrestha, M, Meck, S, et al. Hypothermic circulatory arrest with selective antegrade cerebral perfusion in ascending aortic and aortic arch surgery: a risk .

(PDF) Deep hypothermic circulatory arrest

We conclude that deep hypothermia with circulatory arrest is a safe technique for the repair of complex aortic problems provided both the circulatory arrest and the cardiopulmonary bypass times .

Aortic Dissection Repair | Heart and Vascular Center .

In other cases, a technique known as axillary cannulation (or the insertion of a drainage tube, known as a cannula, in an artery in your armpit, or axilla) can allow aortic replacement to be performed without hypothermic circulatory arrest; this advance may reduce the incidence of postoperative strokes and neurological deficits.

The Clinical Experience of The Descending Thoracic and .

There were 17 aortic dissections, 17 aortic aneurysms, one coarctation of aorta and one traumatic aortic aneurysm. The thoracic aortic replacement was performed under a femorofemoral bypass, an LA to femoral bypass, or a deep hypothermic circulatory arrest.

Normothermic frozen elephant trunk surgery without .

Different from other previously reported techniques, our approach completely avoids circulatory arrest and allows a normothermic ECC conduction while providing a perfectly bloodless and maneuverable operative field, as the balloon is retrogradely (and not antegrade) advanced into the stent graft for aortic clamping. While all arch aneurysms .

Early Results of a Novel Single-Stage Hybrid Aortic Arch .

Under circulatory arrest, the proximal aortic arch is resected and the wire externalized. Antegrade deployment of a stent graft is performed into the aortic arch and proximal descending aorta. The ascending aortic graft is sewn to the cut end of the aorta, incorporating the stent graft. The graft is cannulated and cardiopulmonary bypass .

Modified hypothermic circulatory arrest for emergent .

May 09, 2013 · Deep hypothermic circulatory arrest (DHCA) with antegrade cerebral perfusion has been historically preferred for organ protection during surgical repair of the acute aortic dissection type A. However, in the past decades, different perfusion-specific strategies with a growing trend to increase the body temperature at circulatory arrest emerged.

Oxygen saturation and haemodynamic changes prior to .

Circulatory failure can be further subdivided into a cardiac cause, where at the point of cardiac arrest the rest of the body is physiologically relatively normal, or a non-cardiac cause, where the cardiac arrest is as a result of a catastrophic failure of the heart secondary to external factors. 2 Overwhelmingly the most common non-cardiac .

Circulatory Arrest and Cardiopulmonary Bypass Hypothermia .

Dec 26, 2019 · In the Boston Circulatory Arrest Study, intraoperative hyperglycemia was not predictive of worse neurodevelopmental outcome after the arterial switch operation. A study by Ballweg et al examined the neurodevelopmental outcomes at age 1 year in 188 infants who underwent cardiac surgery when younger than 6 months. [ 8 ]

COPINION Donation after circulatory death: current status

Category III Awaiting cardiac arrest Controlled Category IV Cardiac arrest in brain-dead donor Classification of nonheart-beating donors according to the Maastricht classification, initially developed by Kootstra et al. Table 1 is adapted from [1] and original work. Donation after circulatory death: current status Neyrinck et al.

Short-term outcomes of modified Y-graft technique in acute .

May 20, 2020 · Aortic arch replacement in acute type A aortic dissection patients remains the most challenging cardiovascular operation. Herein, we described our modified Y-graft technique using the Femoral Artery Bypass (FAB) and the One Minute Systemic Circulatory Arrest (OSCA) technique, and assessed the short-term outcomes of the patients. Between February 2015 and November 2017, 51 .

Hypothermic circulatory arrest in cerebral aneurysm surgery

Rimmer L, Fok M, Bashir M (2014) The History of Deep Hypothermic Circulatory Arrest in Thoracic Aortic Surgery. AORTA (Stamford) 2: 129-134. Naef A (2004) The mid-century revolution in thoracic and cardiovascular surgery: part 4. Interact Cardiovasc Thorac Surg 3: 213-221.

Sutureless AVR under Deep Hypothermic Circulatory Arrest .

May 26, 2019 · Sutureless AVR (Perceval S) under deep hypothermic circulatory arrest in a patient with unclampable ascending aorta by Dr. Jae Suk Yoo, Cardiac Surgeon, Sejong General Hospital, South Korea.

The Clinical Experience of The Descending Thoracic and .

There were 17 aortic dissections, 17 aortic aneurysms, one coarctation of aorta and one traumatic aortic aneurysm. The thoracic aortic replacement was performed under a femorofemoral bypass, an LA to femoral bypass, or a deep hypothermic circulatory arrest.

Pharmacological agents as cerebral protectants during deep .

The use of pharmacological agents as cerebral protectants during deep hypothermic circulatory arrest (15–18 °C) in adult patients undergoing thoracic aortic surgery. (Please circle or tick) Are you involved in thoracic aortic surgery with hypothermic circulatory arrest: YES/NO

Provision of ECPR during COVID-19: evidence, equity, and .

Jul 27, 2020 · The use of extracorporeal cardiopulmonary resuscitation (ECPR) to restore circulation during cardiac arrest is a time-critical, resource-intensive intervention of unproven efficacy. The current COVID-19 pandemic has brought additional complexity and significant barriers to the ongoing provision and implementation of ECPR services. The logistics of patient selection, expedient cannulation .

Circulatory Arrest and Cardiopulmonary Bypass Hypothermia .

Dec 26, 2019 · In the Boston Circulatory Arrest Study, intraoperative hyperglycemia was not predictive of worse neurodevelopmental outcome after the arterial switch operation. A study by Ballweg et al examined the neurodevelopmental outcomes at age 1 year in 188 infants who underwent cardiac surgery when younger than 6 months. [ 8 ]

Deep hypothermic circulatory arrest | BJA Education .

• Deep Hypothermic Circulatory Arrest (DHCS) is a technique used mainly to facilitate complex aortic arch surgery. • Deep hypothermia reduces cellular metabolism and protects tissues from ischaemia during circulatory arrest, most importantly the central nervous system.

Ascending and Arch Aorta | Circulation

The popularization of deep hypothermic circulatory arrest (HCA) as an adjunctive technique to allow a "safe" period of cerebral ischemia by Griepp and colleagues revolutionized aortic arch repair. 41 The premise of this approach relies on the observed reduction of metabolism noted with deep hypothermia (15 to 18°C), which in turn affords a .

Noninvasive Neuromonitoring of Hypothermic Circulatory .

Background and Aims:Circulatory arrest carries a high risk of neurological damage, but modern monitoring methods lack reliability, and is susceptible to the generalized effects of both anesthesia a.