Keeping the heart empty and beating improves preservation of hypertrophied hearts for valve surgery

Wang, Jian; Liu, Hongyu; Xiang, Bo; Li, Gang; Gruwel, Marco L.H.; Jackson, Michael; Tomanek, Bogusław; Salerno, Tomás A.; Deslauriers, Roxanne; Tian, Ganghong

doi:10.1016/j.jtcvs.2006.07.010

Cited by 39 publications

(30 citation statements)

References 28 publications

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“…Conventional myocardial protective strategies may result in postoperative left ventricular dysfunction, especially in patients with preoperative myocardial dysfunction and in those requiring prolonged periods of aortic cross-clamping. Experimental studies by our group [14,15] demonstrated decreased accumulation of extracellular fluid, diminished lactate production, and greater preservation of high energy stores when a strategy of myocardial protection with simultaneous antegrade/retrograde continuous normothermic, normokalemic blood perfusion was used as compared to conventional cardioplegic arrest.…”

Section: Discussionmentioning

confidence: 99%

Resultados da abordagem transeptal para a valva mitral com coração batendo

Salerno¹,

Suarez²,

Panos³

et al. 2009

Rev Bras Cir Cardiovasc

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Results of beating heart mitral valve surgery via the trans-septal approachResultados da abordagem transeptal para a valva mitral com coração batendo Resumo Objetivo: A cirurgia da valva mitral pode ser feita via transatrial ou transeptal. Embora a transatrial seja a preferida, a via transeptal tem sido utilizada mais recentemente e tido um grande valor nas operações com o coração batendo. Mostramos a nossa experiência na cirurgia da valva mitral via transeptal com coração batendo e discutimos seus benefícios e problemas. AbstractObjective: Mitral valve surgery can be performed through the trans-atrial or the trans-septal approach. Although the trans-atrial is the preferred method, the trans-septal approach has also been used recently and has a particular value in beating-heart mitral valve surgery. Herein we report our experience with beating-heart mitral valve surgery via trans-septal approach, and discuss its advantages and pitfalls.Methods: Between 2000 and 2007, 214 consecutive patients were operated upon utilizing beating heart technique for mitral valve surgery. The operation was performed via transseptal approach with the aorta unclamped, the heart beating, with normal electrocardiogram and in sinus rhythm.Results Rev Bras Cir Cardiovasc 2009; 24(1): 4-10 and 83 (38.8%) females. Of the prostheses used, 108 (50.5%) were biological, and 39 (18.2%) were mechanical. Mitral repairs were performed in 67 (31.3%) patients. Mean hospital stay was 17.4 ± 20.0 days (range: 3-135 days; median: 11 days). Intra-aortic balloon pump (IABP) utilization was required in 12 (5.6%) of 214 patients. One-month mortality was 7.4%, and re-operation for bleeding was needed in 15 (7%) patients.

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Section: Discussionmentioning

confidence: 99%

Resultados da abordagem transeptal para a valva mitral com coração batendo

Salerno¹,

Suarez²,

Panos³

et al. 2009

Rev Bras Cir Cardiovasc

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“…This is because beating heart surgery prevents the potential detrimental effects of cardioplegia, such as myocardial edema and overload of potassium and chloride [7]. Development of an effective perfusion technique to protect the hypertrophied beating heart has become an urgent issue.…”

Section: Discussionmentioning

confidence: 99%

“…A heparinized polyethylene catheter was inserted into the LV chamber to measure the intra-ventricular pressure. Detailed method for isolation of the pig hearts has been described in our previous study [7]. In brief, after opening chest, the aorta, pulmonary artery, and inferior and superior vene cave were dissected and clamped.…”

Section: Pig Model Of Pressure-overloaded Left Ventricular Hypertrophymentioning

confidence: 99%

“…Moreover, dynamic 3-D architecture of a beating heart may facilitate intra-operative examination of aortic and mitral valve [5,6]. Our previous study demonstrated that keeping the heart beating with empty ventricles improved myocardial homeostasis for hypertrophied hearts relative to cardioplegic arrest [7]. Sufficient homogeneous myocardial perfusion is the prerequisite for adequate myocardial preservation.…”

Section: Introductionmentioning

confidence: 99%

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Alternate antegrade/retrograde perfusion: an effective technique to preserve hypertrophied hearts during valvular surgery☆

Wang

Liu

Salerno

et al. 2009

European Journal of Cardio-Thoracic Surgery

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“…Avoidance of the adverse consequences of cardioplegia has been the driving force behind the development of on-pump beating heart surgery (13). Although beating heart procedures is associated with less myocardial damage (13)(14)(15), heart motion and a less optimal surgical field of view can make procedure challenging and increases the risk of air embolism (16). Thus, the application of the on-pump beating heart procedure is still limited and currently depends on the attitude and experience of the surgeon performing the operation.…”

Section: A B a B Cmentioning

confidence: 99%

Surgical resection of right ventricular rhabdomyoma under the guidance of transesophageal echocardiography on a beating heart

et al. 2017

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Cardiac rhabdomyoma, a type of benign myocardial tumor, is regarded as the most common fetal cardiac tumor. Rhabdomyomas are usually found before birth or during the first year of life. It is widely accepted that rhabdomyomas are strongly associated with tuberous sclerosis, and tend to regress spontaneously without surgical excision. However, if the tumor has caused significant obstruction or refractory arrhythmias, the surgery should be advocated. Most of the surgeries for pediatric cardiac tumors are performed under cardiopulmonary bypass (CPB) with cardioplegia. Here, we present a case of successful resection of a right ventricular rhabdomyoma obstructing the right ventricular outflow tract (RVOT) and involving pulmonary valve annulus in an infant, performed under the guidance of transesophageal echocardiography (TEE) on a beating heart.

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Keeping the heart empty and beating improves preservation of hypertrophied hearts for valve surgery

Cited by 39 publications

References 28 publications

Resultados da abordagem transeptal para a valva mitral com coração batendo

Resultados da abordagem transeptal para a valva mitral com coração batendo

Alternate antegrade/retrograde perfusion: an effective technique to preserve hypertrophied hearts during valvular surgery☆

Surgical resection of right ventricular rhabdomyoma under the guidance of transesophageal echocardiography on a beating heart

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