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

Fourteen infants with complete common atrioventricular canal (CCAVC) underwent open heart surgery under deep hypothermia and circulatory arrest. There were three operative deaths and two late deaths. Postoperative studies performed in seven of the nine survivors revealed nearly normal hemodynamics. There were no residual shunts, and excellent mitral valve function was observed in six patients. In one patient, residual mitral regurgitation was noted. The pulmonary artery pressures and pulmonary vascular resistances were normal except in one who had severe pulmonary vascular obstructive disease before surgery. The mean left ventricular end-diastolic volume changed from 175 +/- 24% (SEM) before surgery to 106 +/- 7% after surgery (P less than 0.01). The corresponding right ventricular end-diastolic volume changed from 166 +/- 16% to 102 +/- 19% (P less than 0.025). Left ventricular ejection fraction was mildly decreased before and after surgery (0.63 +/- 0.02). Surgical repair of CCAVC is possible during the first year of life, with likely normalization of cardiac size and function. Unsatisfactory results related to pulmonary vascular obstruction may be anticipated if repair is delayed much beyond the first year.
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PMID:Complete common atrioventricular canal in infancy--surgical repair and postoperative hemodynamics. 67 47

A 10-month-old infant, the youngest patient thus far reported to have undergone successful correction of the developmental complex known as "parachute mitral valve," is presented. Severe mitral incompetence and aortic coarctation led to recurrent cardiac failure. Both anomalies were corrected in a one-stage procedure wherein the coarctation was resected under normothermia and the mitral valve replaced thereafter by a prosthesis employing deep hypothermia and total circulatory arrest. He made an uneventful recovery. Forty-two reported cases in the literature are reviewed and the pathologic and clinical features, diagnosis, natural history, and management briefly summarized.
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PMID:The parachute mitral valve complex. Case report and review of the literature. 116 37

A case of urgent application of craniocerebral hypothermia (CCH) during correction of traumatic mitral insufficiency developing in the course of closed mitral commissurotomy is described. The occlusion duration was 46.5 min, with the temperature in the esophagus 30.2 degrees C. No postoperative neurological disturbances have been observed. Three years after surgery the patient was in a satisfactory condition. It is demonstrated that CCH is associated with a more marked antihypoxic effect, than it has been earlier believed, and that it is possible to use intravenous ketamine anesthesia during CCH in patients with low cardiac output syndrome.
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PMID:[A case of long-term occlusion in craniocerebral hypothermia]. 178 92

The purpose of this study was to develop anesthetic and postoperative methods that could be used in a canine model of reversible left ventricular volume overload (LVVO). LVVO was created by inducing mitral regurgitation (MR) in adult conditioned dogs. Using fluoroscopy, MR was induced by passing urologic grasping forceps into the left ventricle through a carotid artery and rupturing one or more chordae tendinea. Cardiac catheterization was performed after significant cardiac dysfunction developed (3 months after creation of MR) in order to collect data to confirm reduced contractile function. The MR was repaired by replacing the damaged valve with a bovine pericardial xenograft. Dogs were followed with sequential cardiac catheterizations to determine if the valvular replacement reversed the cardiac dysfunction. To develop this model, unique anesthetic and post-operative care protocols had to be instituted. In order not to exacerbate the existing cardiac dysfunction, a high dose narcotic anesthetic regimen using a sufentanil infusion at 9-13 microgram/kg h-1 was developed in association with cardiopulmonary bypass and hypothermia for the mitral valve replacement surgery. Intensive postoperative care protocols that involved major personnel and pharmaceutic interventions were necessary. Using our methods 11/17 dogs survived the procedure and were included in the protocol for study of mechanisms involved in reversal of cardiac dysfunction.
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PMID:Anesthetic and postoperative protocols for a canine model of reversible left ventricular volume overload. 183 53

We report our experience with 103 consecutive children who underwent repair of complete atrioventricular septal defect between 1971 and 1990. Ninety-one patients were less than 18 months old (mean age, 6.2 months; mean weight, 5.8 kg) and were repaired using deep hypothermia and circulatory arrest. There were 15 perioperative deaths. Twelve patients were older (mean age, 40.2 months; mean weight, 18.9 kg) and were repaired using moderate hypothermia and cardiopulmonary bypass. There were two perioperative deaths. Repairs were performed with the single-patch technique. Four younger patients required repeat repair to control residual mitral regurgitation. Two of the older children required late reoperation to replace one or both atrioventricular valves. Three younger children underwent pulmonary artery banding initially; 1 died after complete repair. Three older children underwent initial pulmonary artery banding; 2 died at definitive repair, and the survivor required pulmonary artery reconstruction, which was repeated subsequently. Since 1977 our policy has been to perform primary definitive repair whenever possible. Two patients died late from unrelated causes. At the most recent follow-up the majority of patients had no or minimal symptoms. We continue to advocate primary definitive repair whenever possible using the single-patch technique in symptomatic patients with complete atrioventricular septal defect.
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PMID:Complete repair of atrioventricular septal defect. 206 58

During the development of methods to protect the heart from ischaemic injury, attention has been focused on protection of the left ventricle. In an attempt to assess right heart preservation. 55 consecutive patients undergoing open heart surgery were studied. Mean aortic cross-clamp time was 59.3 +/- 29.4 min. Temperature probes were inserted into the right atrium (RA), right ventricle (RV), and left ventricle (LV). During cardioplegia, the mean myocardial temperatures of RA, RV and LV were 19.1 degrees +/- 4.1 degrees C, 12.7 degrees +/- 4.8 degrees C and 7.3 degrees +/- 3.4 degrees C, respectively. Of the LV temperature measurements, 67.2% were 10 degrees C or lower. By contrast, 94.1% of RA measurements and 58.5% of RV measurements were above 10 degrees C. The inhomogeneity of chamber temperatures was observed irrespective of the patient's disease or age and whether the atrium or right ventricle were open or not. Hearts with mitral regurgitation (MR), in contrast to mitral stenosis and stenoinsufficiency, had higher LV temperatures, similar to those in the RV. We conclude that there is uneven hypothermia among the three cardiac chambers during hypothermic cardioplegic arrest, regardless of disease states except MR and regardless of age and procedure performed.
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PMID:Uneven myocardial hypothermia among cardiac chambers during hypothermic myocardial preservation. 226 42

Craniocerebral hypothermia was used during open-heart surgery in 69 patients with mitral stenosis (hospital mortality rate 2.9%). Indications for open-heart surgery (left atrial thrombosis, mitral valve calcinosis, onset of traumatic mitral insufficiency) were determined intraoperatively during closed mitral commissurotomy. Some pathophysiological peculiarities of craniocerebral hypothermia were studied. A decrease in brain temperature and total oxygen consumption (up to 27.7% of the basic metabolism level) has been observed. Prolongation (up to 25 min) of major vessel occlusion had no negative effect on the patients' condition, postoperative complications and lethality. Craniocerebral hypothermia is considered to be a safe and effective technique indicated in case of emergency for open-heart surgery.
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PMID:[Emergency craniocerebral hypothermia in the management of open mitral commissurotomy]. 239 75

A successful case of simultaneous modified Bentall' procedure, MVR and sternoplasty was presented for a 42 years old man of Marfan's syndrome who had funnel chest, combined with mitral regurgitation, aortic regurgitation and annuloaortic ectasia. A few reports of one stage operation for the combination of funnel chest and heart disease in Marfan's syndrome has been published. A median sternotomy was made, with total cardiopulmonary bypass, heart was arrest and cor cooling hypothermia with crystalloid cardioplegic solution. Mitral valve was replaced with #31 B-S prosthetic valve. The ascending aorta proximal to the innominate artery and the aortic valve were replaced en-bloc with composite graft made of a vascular graft and aortic valve prostheses. Coronary artery orifices cut to the button-shaped, were sutured to the composite graft. Finally, sternoplasty was completed through modified Ravitch sterno-elevation. This is the first report in Japanese journals.
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PMID:[Simultaneous corrections Bentall procedure, mitral valve replacement and sternoplasty for a patient with Marfan's syndrome]. 261 23

Data of emergency correction of traumatic mitral insufficiency in 15 patients after closed mitral commissurotomy under conditions of craniocerebral hypothermia without artificial blood circulation are presented. Prostheses of the mitral valve were made in 3 patients, plastic valve-preserving interventions--in 12 patients. One patient died. The authors consider that in most cases with traumatic insufficiency of the mitral valve after closed commissurotomy it is possible to perform valve-preserving operations, craniocerebral hypothermia being a reliable method of their maintenance.
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PMID:[Emergency correction of traumatic mitral valve insufficiency under craniocerebral hypothermia]. 263 67

The ultrastructure of biopsy specimens obtained from the left ventricle was examined at varying stages of mitral valve replacement under non-perfusion hypothermal protection (at 27-28 degrees C). In patients with clinical stage IV mitral incompetence, cardiomyocytes were shown to combine signs of marked hypertrophy and decompensation. Despite the initial plastic muscular cell incompetence, there are only small changes in their ultrastructure and myofibril contracture in the pre-occlusion period, which subside by the end of long-term (up to 37 min) occlusions. For the myocardium, reperfusion is the most damaging, but the damages, though widely diverse, are regarded mainly as moderate and reversible. Over again the electron microscopic finding provide good evidence for the feasibility of performing complicated cardiac surgeries with prolonged reversible exclusion of blood circulation under non-perfusion hypothermia.
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PMID:[Ultrastructure of cardiomyocytes during mitral valve replacement in non-perfusion hypothermia]. 271 33


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