Simultaneous Antegrade/Retrograde Normothermic Perfusion with Blood (Beating Heart) for Aortic Root Replacement in Acute Type-A Dissection of the Aorta

Luozzo, Gabriele Di; Panos, Anthony L.; Lombardi, Pierluca; Salerno, Tomás A.

doi:10.1111/j.1540-8191.2005.200463.x

Cited by 12 publications

(16 citation statements)

References 4 publications

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“…We have routinely perfused the coronary sinus with mean pressures of 50 to 55 mmHg without consequences. In this series of patients, there was not a single coronary sinus injury, or observed edema of the myocardium due to simultaneous antegrade/retrograde perfusion 7 . Systematic de‐airing maneuvers were performed in all patients without any problem 14 …”

Section: Discussionmentioning

confidence: 88%

“…This is particularly important in patients with left ventricular hypertrophy, who may require complex procedures, with prolonged aortic cross‐clamping 4 . Beating heart valve surgery may offer some benefit over conventional hypothermic cardioplegic arrest, 5‐7 including continuous perfusion of the heart, less ischemia‐reperfusion injury, decreased need for inotropic support, decreased mechanical ventilation time, and fewer postoperative complications 6 …”

mentioning

confidence: 99%

“…3 This is particularly important in patients with left ventricular hypertrophy, who may require complex procedures, with prolonged aortic cross-clamping. 4 Beating heart valve surgery may offer some benefit over conventional hypothermic cardioplegic arrest, [5][6][7] including continuous perfusion of the heart, less ischemia-reperfusion injury, decreased need for inotropic support, decreased mechanical ventilation time, and fewer postoperative complications. 6 We previously reported a patient with LVEF of 15% who successfully underwent beating heart aortic valve (AV) replacement, using continuous warm blood myocardial perfusion, delivered simultaneously antegrade/retrograde.…”

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confidence: 99%

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Beating Heart Valve Surgery in Patients with Low Left Ventricular Ejection Fraction

Macedo¹,

Carvalho²,

Hassan³

et al. 2010

Journal of Cardiac Surgery

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Section: Discussionmentioning

confidence: 88%

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confidence: 99%

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confidence: 99%

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Beating Heart Valve Surgery in Patients with Low Left Ventricular Ejection Fraction

Macedo¹,

Carvalho²,

Hassan³

et al. 2010

Journal of Cardiac Surgery

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“…Another option is to perform the distal anastomosis using continuous myocardial perfusion by the retrograde route alone. This is well tolerated for the short period required to construct that anastomosis 16 . However, we do not recommend performing the entire aortic repair keeping the heart beating and perfused by the retrograde route alone.…”

Section: Methodsmentioning

confidence: 99%

Surgery for Cardiac Valves and Aortic Root Without Cardioplegic Arrest ("Beating Heart"): Experience with a New Method of Myocardial Perfusion

et al. 2007

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Simultaneous antegrade/retrograde warm blood perfusion with a beating heart has not been previously reported as a mean of protecting hypertrophied hearts in cardiac valve and aortic root surgeries. Similarly, beating heart mitral valve surgery via the trans-septal approach with the aorta unclamped, is a novel technique. We, herein, report a series of 346 patients with a variety of cardiac pathologies who were operated upon utilizing a new modality of myocardial perfusion. Among this group of patients, there were 55 patients who were diagnosed with endocarditis of one or more valves. These patients were excluded from this series of patients. Mean age was 59 +/- 12, and there were 196 (67.3%) males and 95 (32.7%) females. There were six aortic root procedures, 90 mitral valve replacements (MVR), 46 mitral valve repairs, 20 MVR+ coronary artery bypass grafting (CABG), 28 tricuspid valve repairs, 106 aortic valve replacements (AVR), 17 AVR+CABG, and 8 AVR/MVR. Crude mortality for the group was 20 of 291 (6.8%). Intra-aortic balloon pump utilization at time of weaning from cardiopulmonary bypass was 6/291 (2.06%), and re-operation for bleeding was needed in 12 of 291 (4.1%) patients. Postoperative stroke occurred in 4 of 291 (1.3%) patients. In these patients, the clinical diagnosis of stroke was made prior to surgery. This initial experience with this new method of myocardial perfusion indicates that results are at least comparable, if not superior, to conventional techniques utilizing intermittent cold blood cardioplegia.

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“…Although beating heart surgery had been used in the early days of cardiac surgery, it was only recently that several surgical groups including ours [1,2] reported mitral valve surgery without cardioplegia. The operation is performed on a beating heart, minimizing or eliminating ischemia-reperfusion injury due to aortic cross-clamping and myocardial ischemia.…”

Section: Introductionmentioning

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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Simultaneous Antegrade/Retrograde Normothermic Perfusion with Blood (Beating Heart) for Aortic Root Replacement in Acute Type-A Dissection of the Aorta

Cited by 12 publications

References 4 publications

Beating Heart Valve Surgery in Patients with Low Left Ventricular Ejection Fraction

Beating Heart Valve Surgery in Patients with Low Left Ventricular Ejection Fraction

Surgery for Cardiac Valves and Aortic Root Without Cardioplegic Arrest ("Beating Heart"): Experience with a New Method of Myocardial Perfusion

Resultados da abordagem transeptal para a valva mitral com coração batendo

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