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

Two cases of delayed non-mycotic false aneurysm arising from ascending aortic cannulation site, presenting one-and-a-hald years and seven years after cardiopulmonary bypass, are described. These two cases represent an incidence of 0.12% of this complication. Repair using profound hypothermia and circulatory arrest with femoral artery and femoral vein cannulation for cardiopulmonary bypass is recommended. The advantages and complications of aortic cannulation are discussed and recommendations to minimise the complications of cannulation are made. The clinical presentation and diagnosis of non-mycotic false aneurysms arising from the aortic cannulation site are described. In addition one delayed and two early cases of non-mycotic cannulation site false aneurysms previously published are analysed. Surgeons should be alert to the possibility of this complication in all patients who have had aortic cannulation for cardiopulmonary bypass even in the distant past. Unexpected symptoms such as constant anterior chest pain, dysphagia, hoarseness, and increasing widening of the superior mediastinum on the chest radiograph warrant prompt investigation.
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PMID:Delayed non-mycotic false aneurysm of ascending aortic cannulation site. 60 39

Surgical closure of a left coronary artery-left ventricular fistula in a 44-year-old black man is reported. The fistula was discovered by coronary arteriography after the patient was admitted to the hospital complaining of recurrent chest pain. The fistula was closed with cardiopulmonary bypass, ischemic arrest, and hypothermia, and there was an uneventful postoperative recovery. The previously reported five cases of fistulas terminating in the left ventricle that were closed surgically are reviewed. Four of these cases originated in the right coronary artery and one in the left coronary artery. Three of the six patients were symptomatic at the time of discovery of the lesion. Cardiopulmonary bypass was necessary in five of the six cases. One patient died in the postoperative period from intractable hemorrhage. It is recommended that coronary artery fistulas by closed upon establishment of the diagnosis because of the sequelae if they are allowed to remain open; these include premature atherosclerosis, aneurysmal dilatation of the coronary artery, and congestive heart failure.
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PMID:Surgical closure of left coronary artery-left ventricular fistula: the second case reported in the literature and a review of the five previously reported cases of coronary artery fistula terminating in the left ventricle. 88 74

A case of pseudocoarctation with dissecting aneurysm of the ascending aorta and arch is reported. A 49-year-old man was admitted with chest pain and loss of consciousness. Angiogram showed kinking of the aortic isthmus and dissecting aneurysm of the ascending aorta. There was no pressure gradient between arms and legs. Prosthetic graft replacement of the ascending aorta was successfully performed by the use of total cardiopulmonary bypass with moderate hypothermia. Etiology of the development of pseudocoarctation is unknown, however, hypothesis that embryological abnormality of the aortic arch is one of the contributing factors has been widely accepted. This case was accompanied by bicuspid aortic valve. It is suggested that the developmental etiology of this case seems to be similar to that of classical coarctation of the aorta. Development of the dissecting aneurysm is supposed to be due to hypertension of the upper body during exercise, even though there is no pressure gradient at rest.
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PMID:[Pseudocoarctation associated with dissecting aneurysm of the aorta: a case report]. 151 14

A successful emergency replacement of the ruptured ascending thoracic aorta by means of ringed Dacron tube graft for 69-year-old male was presented, who had been admitted to our hospital with deep cyanosis and shock. He had experienced severe chest pain one hour prior to admission followed by mental confusion and was brought by ambulant service. Emergency chest enhanced computed tomography showed a clear ruptured dissecting aneurysm (DeBakey Type I) with complicated with pericardial tamponade. Soon after this admission he developed bradycardia with hypotension and quickly went into shock. After induction of anesthesia, cardiac arrest developed. External cardiac massage was started at the same time. Partial cardiopulmonary bypass using femoral vein to artery bypass with the membrane oxygenator was instituted and the body was cooled until moderate hypothermia (25 degrees C). The pericardium was opened and blood clot was removed. The ascending aorta ruptured which was replaced with ringed Dacron tube graft (24 mm in diameter). Patient tolerated procedure well and made good postoperative recovery with temporally mild mental confusion. He discharged 2 months after the surgery without any neurological or mental complication. He has been followed up for six months in excellent condition.
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PMID:[A successful emergency surgical treatment of DeBakey type I dissecting aneurysm complicated with cardiac tamponade and bleeding shock]. 156 16

It is known that bicuspid aortic valve is a risk factor of aortic dissection in Europe and America, but there is no report of the case in Japan. A 47-year-old male teacher of senior high school had an abrupt onset of chest pain. Aortogram showed localized dissection of the ascending aorta and moderate degree of aortic regurgitation. Cold cardioplegic arrest with moderate systemic hypothermia was used under cardiopulmonary bypass. The aortic valve was bicuspid and localized transverse intimal dissection was also found above left-sided commissure. As both cusps were soft and not degenerative, mattress sutures were used to support the prolapsed cusps against the outer aortic wall. The ascending aorta was replaced with a prosthetic vascular graft. Postoperative clinical course was uneventful and he is doing well two years after the surgery. The bicuspid aortic valve and aortic dissection were also discussed.
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PMID:[A successful case of localized aortic dissection associated with bicuspid aortic valve]. 261 25

Fifteen patients with intracavitary cardiac tumors were operated on at the Kobe University Hospital between September 1977 and January 1984. Three of the patients were men and twelve were women. They ranged in age from 9 to 75 years. Their symptoms were chest pain, dyspnea, cough, palpitation and syncope. Definite diagnosis was confirmed by echo- and cineangiocardiography. There were 14 benign tumors consisting of 13 myxomas, one leiomyoma and one malignant myxosarcoma. The left atrium was the most common chamber involved (12 instances), followed by the right atrium (3). Surgery was performed in all cases under cardiopulmonary bypass with moderate hypothermia and cold crystalloid cardioplegia. Tumors were removed en bloc at the base with their attachment to the atrial septum or free wall in all cases. Three patients underwent concomitant mitral annuloplasty or mitral commissurotomy. Two cases with left atrial myxoma died postoperatively: one case associated with mitral annuloplasty died of congestive heart failure due to newly developed chordal rupture two months after surgery, and the other died of congestive heart failure 13 months after the first operation. Re-excision for recurrence of the myxosarcoma in the left atrium was performed in the latter case as a second surgical procedure. The remaining 13 cases with benign tumors are doing well and are without recurrence. From these favorable results, surgical intervention should be recommended prior to the occurrence of heart failure and severe complications such as coronary or peripheral embolism whenever cardiac tumors are detected by non-invasive echocardiography and cineangiocardiography.
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PMID:Surgical management of intracavitary cardiac tumors. A review of fifteen patients and current status in Japan. 378 67

The results of a consecutive series of 24 patients reoperated for coronary bypass grafting between May 1977 and February 1983 are reported. The overall incidence of reoperation was 1.4 p. 100 (24 out of 1 716 cases); the incidence is tending to increase (2.3 p. 100 in 1982). Preoperative assessment revealed the persistence of cardiovascular risk factors: 75 p. 100 of patients had continued to smoke; 61 p. 100 had persistent hyperlipidaemia. The usual presenting syndrome was recurrence of chest pain (21 out of 24 cases) leading to control coronary arteriography on the results of which the surgical indication was based. The average time between the two operations was 38.7 months. The patients were classified into two groups; early reoperation (6 cases) for a technical problem or incomplete revascularisation, and late reoperation (8 cases) for disease of the graft and atherosclerosis. Progression of coronary atherosclerosis was the major long-term cause of occlusion of the saphenous graft (10-14 cases). The arteries most commonly bypassed at reoperation were the left anterior descending and right coronary arteries (12 times each). Reoperation comprised single bypass (13 cases), double bypass (10 cases) and triple bypass (1 case) with an average of 1.5 grafts per patient. The most commonly used vein was the internal saphenous vein (32 out of 36 grafts). Myocardial protection was insured by cardioplegia (13 cases) and intermittent clamping (10 cases) after cooling (general hypothermia at 22 degrees C). Global reoperative mortality (4 p. 100) was higher than for elective primary coronary surgery (2.3 p. 100). The incidence of perioperative infarction was 8 p. 100.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Reoperation after saphenous aortocoronary bypass]. 391 77

We report a rare case of hydatidosis of the right heart. Our young patient had know pulmonary hydatidosis and presented precordial chest pain, increasing dyspnea, cough and hemoptysis. Echocardiography, confirmed by angiocardiography delineated the right ventricular cyst. The operation was performed under extra corporal circulation (ECC), moderate hypothermia with cold cardioplegia. The echinococcal cyst was removed after local instillation of 0.5% silver nitrate solution. The postoperative course was uneventful.
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PMID:Surgical treatment of echinococcal cyst of the right heart. 405 Feb 54

This study examined whether the 8 weeks of initial medical training and 9 d re-certification every 3 yr given to Canadian Forces (CF) Search and Rescue Technicians (SAR Techs) was satisfactory. The course content was compared with 272 held medical case documents for the period 1990-93, inclusive. This practical medical care data showed a predominance of trauma rescue cases: 35% were life threatening conditions and 65% were non-life threatening conditions. They ranged from trauma, chest pain, abdominal pain, hypothermia, diabetic insulin overdose to stroke and gynecological bleeding. Of the life-threatening cases, 32% needed advanced treatment skills and 15% of the non-life threatening cases needed advanced treatment skills. It was concluded that the content of the initial and re-certification medical training was satisfactory as long as immediate transport to a specialist medical center was possible.
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PMID:A review of Canadian Forces Search and Rescue Technician medical training and operations, 1990-93. 872 79

Left ventricular fistulas arising from the left coronary artery are rare, and only 3 cases have been reported Japan. Surgical closure of a left coronary artery-left ventricular fistula in a 14-year old male was reported. The fistula was identified by coronary arteriography after the patient had been admitted to hospital complaining of recurrent chest pain. Ligation of the fistula involving the left anterior descending coronary artery was performed with cardiopulmonary bypass, chemical arrest and hypothermia. The blood flow through the LAD decreased from 370 ml/min to 100 ml/min after the fistula was ligated, and there was uneventful postoperative recovery. Furthermore chest pain of the patient was shown to diminish and movement of the left ventricular septum was improved, compared with the preoperative cineangiography. However, trivial residual flow fo the circumflex coronary artery to the left ventricle remained on postoperative coronary arteriography. The principal aim of the procedure for surgical correction should be effective closure of the fistula without compromising the distal blood supply of the coronary artery involved, cardiopulmonary bypass is considered necessary to appropriate closure of the fistula.
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PMID:[A surgical case of left coronary artery-left ventricular fistula]. 930 64


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