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BACKGROUND Cerebral deoxygenation is associated with various adverse systemic outcomes. We hypothesized, by using the brain as an index organ, that interventions to improve cerebral oxygenation would have systemic benefits in cardiac surgical patients. METHODS Two-hundred coronary artery bypass patients were randomized to either intraoperative cerebral(More)
Surgical repair of transverse aortic arch aneurysms frequently employ hypothermia and antegrade cerebral perfusion as protective strategies during circulatory arrest. However, prolonged mesenteric and lower limb ischemia can lead to significant lactic acidosis and end organ dysfunction, which remains a significant cause of post-operative morbidity and(More)
The design limits of cardiopulmonary bypass (CPB) equipment and the performance characteristics of membrane oxygenators may place the patient with a very large body surface area at risk for incurring an oxygen debt during CPB. The influence of resting muscle tone on systemic oxygen consumption (VO2) during hypothermic (25 to 28 degrees C) nonpulsatile CPB(More)
Myocardial injury was assessed with the use of enzyme indexes in 40 patients randomly assigned to one of two groups undergoing coronary artery bypass surgery. Twenty patients received cold cardioplegia delivered by retrograde coronary sinus perfusion and 20 received cardioplegic solution by anterograde aortic root perfusion. Creatine kinase isoenzyme MB and(More)
OBJECTIVE The aim of this study was to compare the early systemic inflammatory response of the Resting Heart System (RHS; Medtronic, Minneapolis, MN USA), a miniaturized cardiopulmonary bypass (CPB) system, with two groups using a standard extracorporeal circulation system during on-pump coronary artery bypass grafting (CABG) surgery. METHODS A total of(More)
Clinical perfusionists must be able to modify the existing extracorporeal circuit in order to accommodate a specific surgical pathology. The clipping of a giant intracranial middle cerebral artery aneurysm, unapproachable with conventional neurosurgical techniques, required the use of a modified closed cardiopulmonary bypass circuit combined with deep(More)
The purpose of this study is to determine the appropriate arterial pump flow /cardiac index (CI) utilizing a mini-bypass system. The unique feature of most mini-bypass systems is that the centrifugal pump combines the function of kinetic venous drainage with arterial pump flow. Therefore, if drainage is reduced, arterial pump flow is also reduced. Managing(More)
INTRODUCTION The purpose of the study is to clinically evaluate minimally invasive mitral valve surgeries (MIMVS) using a mini bypass circuit. The challenge to perfusion is to keep pace with MIMVS, with demonstrated improvements in perfusion-related technologies. METHODS From October 28, 2005 to September 10, 2008, we retrospectively evaluated thirty-four(More)
We describe an adverse event during minimally invasive cardiac surgery that resulted in a multi-disciplinary review of intra-operative errors and the creation of a procedural checklist. This checklist aims to prevent errors of omission and communication failures that result in increased morbidity and mortality. We discuss the application of the aviation -(More)