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Query: UMLS:C0020672 (hypothermia)
 17,327 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To protect the spinal cord during thoracoabdominal aortic aneurysm repair, motor evoked potentials (MEP) monitoring and cerebrospinal fluid drainage are often employed. Herein, we report a case, where intraoperative diminishment of motor evoked potentials was accompanied by multiple cerebral infarction. A 63-year-old man underwent elective surgery for both thoracoabdominal aortic aneurysm and abdominal aortic aneurysm. He had a past history of cerebral infarction, resulting in Wernicke aphasia but no paralysis. Preoperative magnetic resonance angiography and echocardiography revealed occlusion of the intercostal and lumbar arteries, mild aortic regurgitation, and atherosclerotic lesions at the aortic arch as well as descending aorta. Anesthesia and muscular relaxation were maintained with fentanyl, propofol, and continuous administration of vecuronium at 0.5 mg x kg(-1) x h(-1). The thoracoabdominal aortic aneurysm was repaired under distal aortic perfusion with femorofemoral bypass. After terminating the bypass, we found that the MEP at the lower limb had disappeared. Although we reconstructed intercostal arteries under mild hypothermia and partial bypass, the amplitude of MEP remained very low. Suspecting spinal cord ischemia, we performed cerebrospinal fluid drainage immediately after the operation. On the postoperative day 4, when we stopped the cerebrospinal fluid drainage and propofol administration, his level of consciousness was poor and brain CT revealed multiple cerebral infarction. On the postoperative day 30, he was discharged from an intensive care unit with complications of hemiplagia and paraplegia. Although cerebrospinal fluid drainage may be recommended to protect spinal cord during thoracoabdominal aortic aneurysm repair, we should consider performing brain CT to exclude a risk of brain herniation secondary to cerebrospinal fluid drainage if there is a possibility of cerebral incidents.
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PMID:[A case report of a patient who developed hemiparaplegia with multiple cerebral infarction during thoracoabdominal aortic aneurysm repair]. 1574 19

We report a successful reoperation of aortic valve replacement with the severely calcified, ''porcelain'' aorta due to Takayasu's disease. The patient was a 46-year-old female diagnosed with aortic prosthetic valve failure. Takayasu's aortitis had been noted at 17 years old and the patient underwent aortic valve replacement for aortic regurgitation at age 32. Chest CT scan revealed severe circumferential calcification of the whole thoracic aorta. Echocardiography revealed 100 mmHg of pressure gradient across the aortic prosthetic valve with pannus formation. Replacement of the aortic prosthetic valve was performed using the selective cerebral perfusion method under deep hypothermia. The postoperative course was uneventful without any neurological disorder. Selective cerebral perfusion was a useful method to avoid cross clamping in severely calcified ascending aortic.
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PMID:Redo aortic valve replacement with ''porcelain'' aorta in an aortitis patient. A case report. 1575 82

A 55-year-old man developed acute chest pain and dyspnea. Computed tomography demonstrated a rupture of a giant aneurysm of the ascending aorta. The lesion was 14 cm in diameter--the largest ever reported-and resulted from chronic aortic dissection. The patient did not have aortic insufficiency or aortic dissection around the coronary ostium. Graft replacement of the ascending aorta was performed successfully under deep hypothermia with right hemisphere perfusion.
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PMID:Ruptured giant aneurysm of the ascending aorta caused by chronic aortic dissection. 1661 35

A 29-year-old Marfan patient at 17 weeks of gestation was diagnosed with acute type A aortic dissection and severe aortic regurgitation. Aortic valve and aortic arch replacement was successfully performed under circulatory arrest with deep hypothermia. At 34 weeks of gestation, the patient underwent a cesarean section and delivered a healthy baby.
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PMID:Acute type A dissection at 17 weeks of gestation in a Marfan patient. 1725 12

This paper reports a female patient with. Turner's syndrome and a giant aneurysm of the ascending aorta with pronounced aortic insufficiency in the presence of the bicuspid aortic valve, type II aortic dissection that occurred after two operations: resection of aortic coarctation with end-to-end anstomosis, recoarctation syndrome and aortic ascenoing-descending bypass grafting via the right-sided thoracotomy. The patient underwent prosthetics of the ascending aorta and aortic valve with ascending-descending repeated bypass grafting under conditions of complete peripheral cardiopulmonary bypass, hypothermia (22 degrees C) antegrade brain perfusion via the right subclavian artery.
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PMID:Surgical treatment of a female patient with Turner's syndrome and a giant dissecting aneurysm of the ascending artery which occurred after two operations for aortic coarctation. 1838 7

A 34-year-old Marfan patient at the seventh week of pregnancy presented with acute type A aortic dissection and severe aortic regurgitation. The aortic valve and ascending aorta were replaced successfully using circulatory arrest and deep hypothermia. At 35 weeks of gestation, the patient underwent a cesarean section and delivered a healthy baby. To our knowledge, this case is the first to report a favorable fetal outcome following surgical repair of acute dissection in the first trimester of pregnancy.
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PMID:Acute type A aortic dissection at seven weeks of gestation in a Marfan patient: case report. 1892 96

Aortic dissection is a life-threatening disease that requires immediate surgical intervention. Marfan syndrome is a hereditary disease with an autosomal dominant transmission, which affects the connective tissue, with skeletal, cardiovascular and ocular involvement. It is one of the most prevalent connective tissue disorders, presenting a risk of aortic dissection of approximately 1% even without dilatation of the aorta. When dissection occurs during pregnancy and requires surgical intervention (type A dissection), maternal mortality is high (2096-30%). We report a 38 year-old woman with Marfan syndrome that had an acute type A aortic dissection and severe aortic regurgitation at 37 weeks of gestation. The patient underwent a cesarean section and delivered a healthy baby. Afterwards, aortic valve repair and ascending aortic replacement was successfully performed under circulatory arrest with deep hypothermia. Additionally mitral valve repair for degenerative disease with posterior, autologous pericardium mitral valve ring was performed.
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PMID:[Acute type A aortic dissection in pregnant patient with Marfan syndrome. Report of one case]. 1939 29

Patients with sickle cell abnormalities undergoing surgery are generally considered to be at greater risk for perioperative complications. We present a 25-year-old woman with sickle cell disease (SCD) and severe aortic insufficiency. A minimally invasive, warm, beating heart approach was adopted to try and minimize the risk of sickling due to cardiopulmonary bypass (CPB), low-flow states, cold cardioplegia and aortic cross-clamping. Compared to classical methods, we believe our technique further reduces the risk of systemic and organ hypothermia and thus, sickling.
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PMID:Warm, beating heart aortic valve replacement in a sickle cell patient. 2001 41

A 32-year-old woman at 16 weeks of pregnancy was diagnosed with acute type A aortic dissection and severe aortic regurgitation. Aortic valve and aortic arch replacement was successfully performed under circulatory arrest with deep hypothermia. After the operation, she was diagnosed with Loeys-Dietz syndrome. At 36 weeks of gestation, the patient underwent a cesarean section and delivered a healthy baby.
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PMID:Surgical treatment for acute type A aortic dissection during pregnancy (16 weeks) with Loeys-Dietz syndrome. 2262 60

We present 54 year-old man diagnosed with an aneurysm of the ascending aorta and arch with aortic regurgitation and coronary artery disease. Surgery consisted of removing an aneurysm of the ascending aorta and arch of subtraction (debranching)cephalic brachiocephalic trunk and the common carotid artery and anastomosis of the descending aorta with vascular prosthesis and coronary artery bypass grafting. Postoperative course was uneventful. In 14 days after surgery the patient was discharged from the unit. Debranching method allowed avoiding hypothermia during surgery and shortening the time of cardio pulmonary bypass.
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PMID:[Debranching of aortic arch as part of a complex cardiac surgery]. 2378 91


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