Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020672 (hypothermia)
 17,327 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

From 1984 to 1990, 24 patients suffering from type A aortic dissection were treated by directly suturing the entry orifice of the dissection and glueing (gelatin-resorcin-formaldehyde glue) the dissected aortic tunicae, without any prosthetic replacement. Associated aortic insufficiency in 21 patients was treated by valve replacement (8 patients) or plasty (8 patients). Deep hypothermia with circulatory arrest was required in 13 patients, whose aortic arch was involved by the dissection. All patients survived the operation. All these patients were followed up from 6 to 60 months. All were controlled with Doppler echography. In addition, 21 of them were examined with angiography, 17 with CT and 5 with MRI. 21 patients had an ascending aorta and an apparently normal aortic arch. Limited dissection of the descending aorta, requiring no second surgery, was noted in 2 patients. Persisting dissection of the descending aorta was present in 13 patients. Valve replacement was necessary 18 months later in 1 patient. Heart transplantation was necessary 14 months later in a patient suffering from associated cardiomyopathy. These results demonstrate that aortic glueing is effective and safe in the middle term for the treatment of aortic dissection.
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PMID:[Treatment of type A aortic dissection by exclusive glueing]. 213 38

Between 1984 and 1988, 15 patients with a type A aortic dissection were treated with direct suturing of the entry opening of the dissection and gluing of the dissected aortic layers using the GRF glue (gelatine-resorcine-formaldehyde), without prosthetic replacement. An associated aortic insufficiency, in 10 patients, was treated with valve replacement (5 patients) or plasty (5 patients). Deep hypothermia with circulatory arrest were necessary in 10 patients whose dissection reached the ascending aorta. All patients survived the procedure. These patients are followed from 6 to 44 months. They are all controlled by echo-Doppler. In addition, ten had an angiography, 6 a control scan and 5 a NMR. In twelve patients, the ascending aorta as well as the aortic junction are normal. A limited aortic dissection which did not require a secondary procedure, is found in 3 patients. A dissection of the descending aorta is present in 10 patients. Two patients had to be re-operated: one, for a valve replacement, 18 months later; the other, for a myocardiopathy at the terminal stage, 14 months later, requiring an orthotopic transplantation. These results show that gluing of the aorta is an easy and effective treatment in type A aortic dissections.
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PMID:[Treatment of type A aortic dissection by exclusive gluing. Long-term results apropos of 15 patients]. 231 98

Between 1984 and 1988, 15 patients with type A aortic dissection were treated by direct suturing of the intimal tear and extensive sticking of the dissected aortic layers with surgical (gelatin-resorcin-formaldehyde) glue without prosthetic graft replacement. Aortic incompetence was present in 10 patients, a situation that required valvular replacement in five and valvular repair in five. In 10 patients, the dissection extended to the transverse aortic arch, requiring profound hypothermia and circulatory arrest. All patients survived the operation. Follow-up ranged from 6 to 44 months. All patients were monitored by Doppler echocardiographic studies. In addition, 10 underwent angiography; six, a computed tomographic scan; and five, magnetic resonance imaging. In all patients but two, the ascending aorta and transverse arch had a normal appearance. In three patients, a limited dissection persisted that did not require reoperation. Dissection of the descending aorta was present in 10 patients. One patient required a valvular replacement 18 months after surgery, and one underwent heart transplantation for an associated cardiomyopathy 14 months after surgery. These preliminary results indicate that surgical glue can be used safely and efficiently in type A aortic dissection as an alternative to aortic replacement.
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PMID:Use of surgical glue without replacement in the treatment of type A aortic dissection. 276 35

In type A aortic dissection, the intimal disruption is located on or extends to the transverse arch in about 20% of patients. Replacement of the arch may then be necessary to avoid leaving an unresected, acutely dissected aorta and to prevent bleeding, progression of aneurysm, rupture, and ultimately reoperation or death. From 1970 to September 1987, 119 patients were operated on for type A acute dissection. Starting in January 1977, gelatin-resorcin-formaldehyde biologic glue was used in 91 patients to reinforce the dissected tissues at the suture sites. Among these 119 patients, 26 (ages 32 to 76 years) underwent replacement of the transverse aortic arch in addition to replacement of the ascending aorta. In 20 patients cerebral protection was achieved by profound hypothermia (16 degrees to 20 degrees C) associated with circulatory arrest (15 to 40 minutes, mean 27 minutes) during the distal anastomosis. In six patients the carotid arteries were selectively perfused with cold blood (6 degrees C) during moderate core hypothermia (28 degrees C) while cardiopulmonary bypass was discontinued (19 to 34 minutes, mean 25 minutes) to allow the prosthesis to be sutured without the distal aorta being cross-clamped. Moderate hypothermia avoided the long rewarming time necessitated by profound hypothermia. The hospital mortality rate was 34% (9/26). Two of the 20 patients subjected to profound hypothermia and circulatory arrest died during the operation and seven patients died of postoperative complications. No deaths or major complication were observed in the other six patients. Follow-up of the 17 survivors ranges from 3 to 90 months (mean 39). One patient died 6 months after the operation of cerebral hemorrhage. One patient is disabled by neurologic sequelae. Fifteen patients are in good clinical condition (New York Heart Association class I or II). Postoperative aortograms in 12 patients, and computed tomographic scans in all, have shown a stable repair of the transverse arch in all survivors but a persisting dissection of the descending aorta in 11 (70%). Growing experience and improving results in emergency operations for type A aortic dissection have led us to extend the replacement of the aorta to the transverse arch whenever necessary. The gelatin-resorcin-formaldehyde glue has proved to be an efficient adjunct. The best cerebral protection was obtained in our experience by carotid perfusion with cold blood during circulatory arrest at moderate core hypothermia.
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PMID:Replacement of the transverse aortic arch during emergency operations for type A acute aortic dissection. Report of 26 cases. 275 71