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

The keys to a better outcome in the management of ruptured aneurysm are early diagnosis, aggressive resuscitation, and early operation, with prompt achievement of proximal control. Having achieved these goals, there is a tendency to let down one's guard and relax; indeed, the principles of aneurysm repair beyond this point are similar to those of elective surgery. However, it should be remembered that nearly every complication is more likely in emergency than in elective operations. Therefore, even more care needs to be taken with the technical details at this point to avoid the complications discussed in the following article. The perioperative management must continue at the same heightened level to combat acidosis, hypothermia, coagulation disorders, cardiac dysfunction, fluid overload with pulmonary edema, renal failure, and other common sequelae of this challenging undertaking.
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PMID:Ruptured abdominal aortic aneurysms. Special considerations. 266 51

Emergency cardiac surgery in children can be successfully carried out even when cardiopulmonary bypass is either not feasible or not available quickly enough. Hypothermia induced with ice-water bags, complete circulatory arrest, near-total body exsanguination, and rewarming with a heating blanket and heating lamps, were used twice successfully in the repair of a ruptured aneurysm of the ascending aorta.
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PMID:Hypothermia and exsanguination in emergency cardiovascular surgery in children. 274 20

Partial cardiopulmonary bypass, profound hypothermia, and circulatory arrest were used in the treatment of 25 patients with thoracic aortic aneurysms exposed through left posterolateral incisions. Indications included aortic clamp laceration (4 patients), pulmonary artery tear (1), treatment of ruptured aneurysm without clamping (5), right-sided arch (2), exposure of proximal aorta in a patient with a large aneurysm (1), inability to expose the proximal aorta for clamping (3), to permit removal of both arch and distal aorta (4), and to avoid distal arch clamping because of atheromatous disease (5). Aortic segments ranging from the upper descending thoracic aorta to most of the aorta were replaced, with early survival in 21 patients. Cerebral protection was satisfactory.
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PMID:Partial cardiopulmonary bypass, hypothermic circulatory arrest, and posterolateral exposure for thoracic aortic aneurysm operation. 368 52

During last 7 years, we performed 24 operations on the thoracoabdominal aorta. There were 9 true and 15 dissecting aneurysms. There were two cases of ruptured aneurysm and thoracoabdominal replacement was performed as a last stage operation for total aortic replacement in 4 cases. Three cases with aortic dissection died within 30 days after surgery. Femoro-femoral bypass was used in 4 cases (1 case died of brain damage, paraplegia and MOF), left heart bypass in 5 cases and separate perfusion of upper and lower body (SPULB) under deep hypothermia in 7 cases (2 cases died of LOS and cerebrovascular accident occurred at 2 weeks after operation) and SPULB with mild hypothermia in 8 cases for circulatory support. There was one case of renal dysfunction and transient mild liver dysfunction occurred in 7 cases. There was no evidence on relationship between surgical outcome and methods of circulatory supports, but we recently prefer SPULB under mild hypothermia for thoracoabdominal surgery since intraoperative massive bleeding and cardiac arrest can be easily treated and major organs can be protected by introducing hypothermia in this perfusion technique.
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PMID:[Separate perfusion of upper and lower body under mild hypothermia during operation on the thoracoabdominal aorta]. 756 31

Antero-axillary thoracotomy in a 45 degrees position has become the most frequent approach for lung resection in our country. This approach also offers an ideal view of the aortic arch with the supraaortic vessels being closer to the incision site than in sternotomy or standard thoracotomy. We have therefore used this approach in our last 14 patients with lesions of the distal aortic arch and proximal descending aorta. Operative diagnoses included three arteriosclerotic aortic arch aneurysms, one post-traumatic aneurysm and two acute traumatic transections, as well as four acute type B dissections, three aneurysms after coarctation patch plasty and one recurrent stenosis after primary interposition of a vascular graft. Two patients died of sudden cardiac arrest on the 4th and 6th postoperative day, respectively, both following repair of a ruptured aneurysm. Except for recurrent laryngeal nerve palsy in six patients there were no further operations or morbidity. All operations were performed with the aid of left heart bypass. Induction of deep hypothermia and circulatory arrest, as is advocated for some of these lesions, was not required. This approach is especially useful in those cases where there is indecision as to whether a median sternotomy or a standard thoracotomy would provide the most optimal exposure.
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PMID:"The antero-axillary thoracotomy for operations of the distal aortic arch and the proximal descending aorta". 817 21

The ruptured thoracic aortic aneurysm has had severely high mortality. A 71-year-old male who suddenly fainted away was admitted to our hospital. He was in shock on arrival. Computed tomography and echo cardiogram demonstrated ruptured aortic arch aneurysm with hemorrhagic cardiac tamponade. Aortic arch replacement was performed using the selective cerebral perfusion under deep hypothermia. The recovery of his consciousness was delayed, and he had right hemiplegia postoperatively, but his state was improved gradually. Finally he complained only slight degree of aphasia, paralysis. An immediate and aggressive emergency operation is a only method to salvage the patient who has ruptured aneurysm of the thoracic aorta.
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PMID:[Ruptured aortic arch aneurysm with hemorrhagic cardiac tamponade: report a case]. 983 83

Surgical repair for aortic arch aneurysms is associated with considerable mortality and morbidity. Adequate brain protection is essential. Experience of aortic arch repair in six patients using a four-branched arch graft is described. There were two emergency and three reoperations. One patient had ruptured aneurysm. Hypothermic cardiopulmonary bypass (18-22 degrees C) was employed. A four-branched polymer albumin-coated arch graft was used. The fourth branch of the graft was used for secondary arterial cannulation to ensure continuous brain circulation. One hospital death occurred. No permanent neurological event occurred. The four-branched arch graft facilitates fashioning arch branch anastomoses and provides better brain protection.
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PMID:Aortic arch replacement using a four-branched aortic arch graft. 1178 68

Successful reoperation of a ruptured aortic arch aneurysm in a patient with Takayasu's disease. Takayasu's disease is an inflammatory arteriopathy that often progresses to stenosis or aneurysms of the large arteries of the aortic arch. In this connection aneurysms of the ascending aorta are rare. We report the case of a 33 years old female with a ruptured aneurysm of the ascending aorta complicated by a former operation of a truncobicarotidal bypass and severe sclerosis. After ascending aorta and aortic arch replacement was performed in deep hypothermia circulatory arrest we could discharge the patient in good condition on the 11. postoperative day.
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PMID:[Successful reoperation of a ruptured aortic arch aneurysm in Takayasu arteritis]. 1209 46