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

During the past seven years, 102 patients with TGA have been operated on using the switch operation. Overall early mortality was 5.9%, late mortality 2.%. Sixty-three newborns had an intact septum and were corrected between the 3th and 35th day after birth, 39 had a ventricular septal defect and/or associated anomalies. All operations were carried out under ECC and deep hypothermia. Myocardial function was recorded intraoperatively by using sonomicrometry. The data demonstrate that adaptation of the left ventricle to the new load conditions should be supported by drugs providing inotropic stimulation and afterload reduction. Mean follow-up time is 32.5 months, no rhythm problems have been recorded during that period, a few children revealed trivial pulmonary or aortic valve stenosis and/or incompetence. The switch operation permits good early results for newborns with TGA and intact septum and TGA with VSD. A decade has to pass in order to judge the long-term results.
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PMID:Experience with anatomical correction of transposition of the great arteries (TGA). 178 50

To investigate factors affecting surgical outcome of open heart surgery in neonates, a retrospective review was carried out on 38 patients operated in the 9 years period from May 1981 to August 1990, in our institution (TAPVR19, TGA7, HLHS7, and others 5). In the former 3 years and 9 month period, 12 patients were operated with the use of profound hypothermia and circulatory arrest (Group I) and in the latest 5 year and 5 month period, continuous deep hypothermic bypass was used in all but for 7 patients with HLHS (Group II). In the group of neonates with TAPVR, operative mortality improved to 7% (1 of 14) in Group II compared to that of 60% (3 of 5) in Group I. CVP and LAP measured immediately after cessation of cardiopulmonary bypass (CPB) were lower in Group II and the value of CPK-MB was significantly lower in Group II. There was a significant negative correlation (r = -0.695, p less than 0.05) between CPB time and urine volume for 72 hours after operation. A significant negative correlation (r = -0.899, p less than 0.01) was also obtained between CPB time and urine volume in the group of 7 neonates with TGA. There was no significant difference in urine volume between patients with TAPVR and TGA despite of significantly longer CPB time in patients with TGA. It is concluded that, 1) improved protection of cardiac and renal function was obtained in neonates operated with the use of continuous deep hypothermic bypass, 2) surgical outcome was influenced by the method of CPB, CPB time and differences in cardiac function ascribed to primary lesions.
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PMID:[Results of open heart surgery in neonates--comparison between profound hypothermia with circulatory arrest and deep hypothermic bypass]. 196 Apr 23

The deep hypothermia and cardiocirculatory arrest are employed mainly for two reasons; to reduce as much as possible the extra corporeal circulation time in patients more suitable to present the deleterious effects of the by-pass circulation, and to have surgical field completely free from the blood, making easier some surgical procedures. In the classic description of Hykasa the deep hypothermia necessary to have a safe cardiocirculatory arrest is obtained by means of surface cooling and an extracorporeal heat exchanger. In our experience deep hypothermia and cardiocirculatory arrest were achieved only by means of core cooling technique; 64 patients with TGA weighing less than 10 kg were operated upon by this method with a mortality rate of 3.1%. The most important mortality risk factors were associated to the low weight of the patients and to the age. The major criticism against core cooling is represented by the thought that this type of cooling can impair cerebral function. In 2 patients we had neurological complications but were unrelated to the technique. We conclude that, when is necessary to perform a cardiocirculatory arrest, the core cooling deep hypothermia is a good, simple and useful technique, with a low danger of neurological complications.
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PMID:[Deep hypothermia and cardiocirculatory arrest with the technic of central cooling in patients with simple transposition of the great arteries]. 378 80

Pulmonary artery pseudoaneurysm after PA banding is a rare complication and its mortality is very high. The authors successfully operated on this sort of lesion. To our knowledge, this is the first successful case in Japanese literature. The second of twins was found to be suffering asplenia, dextro cardia, TAPVC, atrioventricular septal defect, corrected TGA and PDA. On the 19th day of life, increasingly pulmonary congestion forced us to operate. We performed PDA ligation, correction of TAPVC, together with extrathoracically adjustable PA banding. 5 months following this operation, spike fever and swelling of anterior thorax were noted. PA angiography was performed, and it showed that the pulmonary artery had been cut through by the band and a pseudoaneurysm had developed. The PA banding was removed and an end-to-end anastomosis of the PA was performed using cardiopulmonary bypass and deep hypothermia with surface cooling. The diameter of the PA anastomosis was designed to be one half that of her aorta. Staphylococcus aureus was cultured from the specimen of the PA band. It was thought to have contributed to the development of this aneurysm. The post operative course was uneventful.
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PMID:[A case of the successful treatment of pulmonary artery pseudoaneurysm after PA banding]. 847 95

The aim of the study was to validate clinically a new technique of myocardial protection developed for intra- and extra-cardiac surgery on the beating heart. The concept combines the principle of continuous pressure- and volume-controlled coronary artery perfusion (PVC-CONTHY-CAP) with the specific myocardioprotective effects of hypothermia and nitrates and, on the other hand, with the beta-blocker-mediated reduction of chronotropy and inotropy necessary for convenient surgery. Under standard ECC conditions after cross-clamping the aorta coronary perfusion with oxygenated blood enriched with nitroglycerine (10 micrograms/kg/h) and esmolol (0.05 mg/ml flow/min) is started via an additional perfusion cannula placed in the aortic root. The temperature of the perfusate is maintained at 32 degrees C, the intraaortic pressure at 40-70 mmHg and the perfusion flow in the range 0.8-1.0 ml/g heart muscle/min. In CABG procedures an additional perfusion catheter is used for perfusion of distal coronary artery segments. Using this technique 100 consecutive patients, adults and children, were operated on between 2/96 and 8/96. In 84 adult patients (age: 45-82 yrs), 78 CABG procedures (54 elective, 13 urgent, 11 acute) with a mean bypass count of 3.7 (range 1-7), 69 ITA grafts, 72 grafts to CX, and 3 MVRec/MVRpl, and 6 pure MVRec/MVRpl procedures (1 urgent, 1 emergency) were performed. The mean coronary perfusion time was 48 min (range 21-88 min). In 5 patients perioperative infarction (CABG; 1 emergency after PTCA, 4 elective) with significant increase of CK-MB values (57-98 U/L) occurred. In the 4 elective patients (3 with diabetes mellitus) re-intervention was not possible due to small-vessel disease. In one patient with preoperative infarction IABP was necessary. No patient died. There were 16 children (age: 4weeks-16 yrs): VSD, n = 6, AV-C, n = 2, TOF, n = 1, MVRec, n = 1, DORV (Rastelli), n = 2, SV (TCPC), n = 3, and PV obstruction, n = 1. The mean coronary perfusion time was 97 min (range: 27-260 min). The mean ICU stay 3.9 d (range: 1-10 d). One child died (TCPC) on the 10th postoperative day due to multi-organ failure. In conclusion, PVC-CONTHY-CAP is designed especially for emergency and urgent procedures, i.e. patients with PTCA-related complications, patients with severely depressed LV function, and patients with complex congenital cyanotic heart defects. Using PVC-CONTHY-CAP, coronary artery bypass grafting as well as intracardiac procedures for congenital and acquired heart defects can be performed safely and conveniently, the system is easy to handle for both the cardiac surgeon and perfusionist. Due to its pharmacological properties continuous intracoronary application of nitrates in combination with hypothermia seems to be essential as a preventive treatment modality for the ischemic state.
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PMID:Myocardial protection by pressure- and volume-controlled continuous hypothermic coronary perfusion (PVC-CONTHY-CAP) in combination with ultra-short beta-blockade and nitroglycerine. 917 18