Perfusion最新文献_第2页

Outcomes following additional drainage during veno-venous extracorporeal membrane oxygenation: A single-center retrospective study. 静脉体外膜氧合过程中追加引流后的效果：单中心回顾性研究。

Perfusion Pub Date : 2024-05-17 DOI: 10.1177/02676591241249609

Sagar B Dave, Eric Leiendecker, Christina Creel-Bulos, Casey Miller, David W Boorman, J. Javidfar, Tamer Attia, Mani A Daneshmand, C. Jabaley, Mark Caridi-Schieble

{"title":"Outcomes following additional drainage during veno-venous extracorporeal membrane oxygenation: A single-center retrospective study.","authors":"Sagar B Dave, Eric Leiendecker, Christina Creel-Bulos, Casey Miller, David W Boorman, J. Javidfar, Tamer Attia, Mani A Daneshmand, C. Jabaley, Mark Caridi-Schieble","doi":"10.1177/02676591241249609","DOIUrl":"https://doi.org/10.1177/02676591241249609","url":null,"abstract":"Refractory hypoxemia during veno-venous (V-V) extracorporeal membrane oxygenation (ECMO) may require an additional cannula (VV-V ECMO) to improve oxygenation. This intervention includes risk of recirculation and other various adverse events (AEs) such as injury to the lung, cannula malpositioning, bleeding, circuit or cannula thrombosis requiring intervention (i.e., clot), or cerebral injury. During the study period, 23 of 142 V-V ECMO patients were converted to VV-V utilizing two separate cannulas for bi-caval drainage with an additional upper extremity cannula placed for return. Of those, 21 had COVID-19. In the first 24 h after conversion, ECMO flow rates were higher (5.96 vs 5.24 L/min, p = .002) with no significant change in pump speed (3764 vs 3630 revolutions per minute [RPMs], p = .42). Arterial oxygenation (PaO2) increased (87 vs 64 mmHg, p < .0001) with comparable pre-oxygenator venous saturation (61 vs 53.3, p = .12). By day 5, flows were similar to pre-conversion values at lower pump speed but with improved PaO2. Unadjusted survival was similar in those converted to VV-V ECMO compared to V-V ECMO alone (70% [16/23] vs 66.4% [79/119], p = .77). In a mixed effect regression model, any incidence of AEs, demonstrated a negative impact on PaO2 in the first 48 h but not at day 5. VV-V ECMO improved oxygenation with increasing flows without a significant difference in AEs or pump speed. AEs transiently impacted oxygenation. VV-V ECMO is effective and feasible strategy for refractory hypoxemia on VV-ECMO allowing for higher flow rate and unchanged pump speed.","PeriodicalId":519219,"journal":{"name":"Perfusion","volume":"11 9","pages":"2676591241249609"},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140965423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Brain injury plasma biomarkers in patients on veno-arterial extracorporeal membrane oxygenation: A pilot prospective observational study. 静脉-动脉体外膜氧合患者的脑损伤血浆生物标志物：一项试点前瞻性观察研究。

Perfusion Pub Date : 2024-05-17 DOI: 10.1177/02676591241256006

Syed Ameen Ahmad, Shrey Kapoor, Siam T. Muquit, Aaron M Gusdon, Shivalika Khanduja, Wendy Ziai, Allen D. Everett, Glenn J R Whitman, Sung-Min Cho, On Behalf Of Herald Investigators

{"title":"Brain injury plasma biomarkers in patients on veno-arterial extracorporeal membrane oxygenation: A pilot prospective observational study.","authors":"Syed Ameen Ahmad, Shrey Kapoor, Siam T. Muquit, Aaron M Gusdon, Shivalika Khanduja, Wendy Ziai, Allen D. Everett, Glenn J R Whitman, Sung-Min Cho, On Behalf Of Herald Investigators","doi":"10.1177/02676591241256006","DOIUrl":"https://doi.org/10.1177/02676591241256006","url":null,"abstract":"INTRODUCTION\u0000Early diagnosis of acute brain injury (ABI) is critical for patients on veno-arterial extracorporeal membrane oxygenation (V-A ECMO) to guide anticoagulation strategy; however, neurological assessment in ECMO is often limited by patient sedation.\u0000\u0000\u0000METHODS\u0000In this pilot study of adults from June 2018 to May 2019, plasma samples of glial fibrillary acidic protein (GFAP), neurofilament light chain (NFL), and tubulin associated unit (Tau) were collected daily after V-A ECMO cannulation and measured using a multiplex platform. Primary outcomes were occurrence of ABI, assessed clinically, and neurologic outcome, assessed by modified Rankin Scale (mRS).\u0000\u0000\u0000RESULTS\u0000Of 20 consented patients (median age = 48.5°years; 55% female), 8 (40%) had ABI and 15 (75%) had unfavorable neurologic outcome at discharge. 10 (50%) patients were centrally cannulated. Median duration on ECMO was 4.5°days (IQR: 2.5-9.5). Peak GFAP, NFL, and Tau levels were higher in patients with ABI vs. without (AUC = 0.77; 0.85; 0.57, respectively) and in patients with unfavorable vs. favorable neurologic outcomes (AUC = 0.64; 0.59; 0.73, respectively). GFAP elevated first, NFL elevated to the highest degree, and Tau showed limited change regardless of ABI.\u0000\u0000\u0000CONCLUSION\u0000Further studies are warranted to determine how plasma biomarkers may facilitate early detection of ABIs in V-A ECMO to assist timely clinical decision-making.","PeriodicalId":519219,"journal":{"name":"Perfusion","volume":"55 10","pages":"2676591241256006"},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140965757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hybrid extracorporeal cannulation for aortic root pseudoaneurysm re-operation: The role of a multidisciplinary team. 用于主动脉根部假性动脉瘤再手术的混合体外插管：多学科团队的作用。

Perfusion Pub Date : 2024-05-16 DOI: 10.1177/02676591241255649

I. Franzese, Florida Gripshi, Marco Anzini, E. Mazzaro

引用次数: 0

Is axillary artery cannulation necessary in type II hybrid aortic arch repair for acute type A aortic dissection? 急性 A 型主动脉夹层的 II 型杂交主动脉弓修复术是否需要腋动脉插管？

Perfusion Pub Date : 2024-05-04 DOI: 10.1177/02676591241252721

Zhonglai Zhu, Long Wu, Yanhong Yuan

{"title":"Is axillary artery cannulation necessary in type II hybrid aortic arch repair for acute type A aortic dissection?","authors":"Zhonglai Zhu, Long Wu, Yanhong Yuan","doi":"10.1177/02676591241252721","DOIUrl":"https://doi.org/10.1177/02676591241252721","url":null,"abstract":"IntroductionAxillary artery cannulation (AAC) has been widely employed in total arch replacement surgeries using the frozen elephant trunk (FET) technique for acute type A aortic dissection (ATAAD), showing better clinical results than femoral artery cannulation (FAC). Nevertheless, in type II hybrid arch repair (HAR), FAC is crucial for lower body perfusion. Hence, it is unclear whether AAC remains necessary or if AAC represents a more advantageous method for initiating cardiopulmonary bypass.MethodsWe conducted a study involving patients diagnosed with ATAAD who underwent type II HAR from August 2021 to December 2022. Demographic baseline and intraoperative data were collected, and the postoperative outcomes of patients receiving FAC only were compared with those receiving AAC.ResultsThere were no significant differences in baseline demographics between patients who underwent FAC alone ( n = 46) and those who underwent AAC ( n = 39). Patients who underwent AAC showed a lower incidence of transient neurological dysfunction (TND) post-surgery compared to those who underwent FAC (12.8% vs 32.6%, p = .032). There were no significant differences between the groups in terms of postoperative mortality within 30 days, permanent neurological dysfunction (PND), length of stay in the intensive care unit (ICU) and postoperative ward, duration of mechanical ventilation, and other complications.ConclusionsAxillary artery cannulation may decrease the incidence of postoperative transient neurological dysfunction (TND) in type II HAR for ATAAD. Nonetheless, studies with larger sample sizes are necessary.","PeriodicalId":519219,"journal":{"name":"Perfusion","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140833218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Successful one-stage surgical repair in a rare adult patient with berry syndrome 为一名罕见的贝里综合征成年患者成功实施了一期手术修复

Perfusion Pub Date : 2024-05-04 DOI: 10.1177/02676591241251438

Sisi Pan, Jue Bai, Feng Wang, Siyuan Yang, Xuanyi Hu, Wanfu Peng, Guiyou Liang

{"title":"Successful one-stage surgical repair in a rare adult patient with berry syndrome","authors":"Sisi Pan, Jue Bai, Feng Wang, Siyuan Yang, Xuanyi Hu, Wanfu Peng, Guiyou Liang","doi":"10.1177/02676591241251438","DOIUrl":"https://doi.org/10.1177/02676591241251438","url":null,"abstract":"BackgroundBerry syndrome is a rare congenital cardiac malformation, herein we report an adult male patient who was successfully repaired by one-stage surgery.Case Description18-year-old male patient presenting symptoms of chest tightness and shortness for over a year presented to outpatient clinic in our department to have corrective procedure heart. CTA revealed an Aortopulmonary Window (APW) type III, measuring 4.6 cm in maximum diameter. The right pulmonary artery originated from the ascending aorta, and the pulmonary trunk exhibited dilation with dimensions of 8.3 cm × 5.7 cm × 5.9 cm. Additional findings included Interrupted Aortic Arch (IAA) type A, intact ventricular septum, and Patent Ductus Arteriosus (PDA). Echocardiography showed bidirectional shunt at the level of APW in severe pulmonary hypertension. The right heart catheterization indicated a mean pulmonary artery pressure of 70mmHg and a pulmonary artery resistance of 5 Wood units. We evaluated after two weeks of treatment with epoprostenol at a rate of 20 ng/(kg. min) and found a significant improvement in pulmonary-artery pressure. Finally, we communicated with the patient's family and decided to proceed with the procedure.ConclusionsFor complex cardiovascular malformations, the ideal treatment strategy must be tailored to the characteristics of the patient to provide maximum efficacy and safety.","PeriodicalId":519219,"journal":{"name":"Perfusion","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140833163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Minimally invasive redo tricuspid valve replacement in patient with persistent left superior vena cava 微创重做三尖瓣置换术治疗左上腔静脉持续存在的患者

Perfusion Pub Date : 2024-05-04 DOI: 10.1177/02676591241247115

Giuseppe Evangelista, Lucrezia Ajrhourh, Xavier Beneux, Jean-Philippe Verhoye, Amedeo Anselmi

引用次数: 0

Impact of aortic root geometry and degree of aortic calcification on outcomes of patients undergoing TAVI procedure 主动脉根部几何形状和主动脉钙化程度对 TAVI 手术患者预后的影响

Perfusion Pub Date : 2024-05-02 DOI: 10.1177/02676591241248537

Ramiz Emini, Christopher Gaisendrees, Marie Kreft, Andreas Liebold, Robert Bauernschmitt, Julia Merkle-Storms

{"title":"Impact of aortic root geometry and degree of aortic calcification on outcomes of patients undergoing TAVI procedure","authors":"Ramiz Emini, Christopher Gaisendrees, Marie Kreft, Andreas Liebold, Robert Bauernschmitt, Julia Merkle-Storms","doi":"10.1177/02676591241248537","DOIUrl":"https://doi.org/10.1177/02676591241248537","url":null,"abstract":"AimsAdequate differentiation of calcifications in contrast-enhanced CT scans remains difficult to assess TAVI parameters. The size of the aortic leaflets has not been taken into account so far in present studies. The aim of our study was to establish a new method for optimized quantification of the aortic valve calcification degree in contrast-enhanced CT scans for better preoperative prediction of postoperative paravalvular leak after TAVI.Methods and resultsWe retrospectively analyzed preoperative contrast-enhanced CT scans of patients who underwent TAVI in our institution between 2014 and 2017. Calcium volume was quantified by a method using contrast enhanced computer tomography (3mensio-Structural Heart-7.2 software) with different iodine contents for better discrimination of contrast agent from calcium and by an individually set Houndsfield Unit (HU) threshold with 50HU above the individually determined reference value. Calcium volume was correlated with surface area of each aortic cusp. Perioperative variables were analyzed. All patients ( n = 150) with severe aortic stenosis were treated with TAVI implantation. Overall incidence of postoperative trace to moderate PVL was 37%. The amount of calcium correlated with the incidence of PVL. In a logistic regression analysis total volume of calcification ( p = .032) as well as calcification of each aortic cusp (NC_ p = .001; RC_ p < .001; LC_ p = .001) were independent predictors.ConclusionsCalcification degree as well as its correlation with the surface area of each aortic cusp significantly influence incidence of PVL. Our new method improves preoperative quantification of the calcification degree by use of contrast agents with different iodine contents and thereby helps to improve patients’ outcomes.","PeriodicalId":519219,"journal":{"name":"Perfusion","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140833389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Improved tricuspid regurgitation after transcatheter aortic valve replacement is associated with better survival: Systematic review and meta-analysis with reconstructed time-to-event data 经导管主动脉瓣置换术后三尖瓣反流的改善与更好的生存率相关：利用重建的时间到事件数据进行系统回顾和荟萃分析

Perfusion Pub Date : 2024-04-30 DOI: 10.1177/02676591241251442

Noritsugu Naito, Hisato Takagi

{"title":"Improved tricuspid regurgitation after transcatheter aortic valve replacement is associated with better survival: Systematic review and meta-analysis with reconstructed time-to-event data","authors":"Noritsugu Naito, Hisato Takagi","doi":"10.1177/02676591241251442","DOIUrl":"https://doi.org/10.1177/02676591241251442","url":null,"abstract":"BackgroundThis meta-analysis compared survival outcomes among patients experiencing improvement in untreated significant tricuspid regurgitation (TR) following transcatheter aortic valve replacement (TAVR) for severe aortic stenosis, in contrast to those without improvement.MethodsMEDLINE and EMBASE were searched through January 2024. Pooled hazard ratios (HR) with 95% confidence intervals (CI) were computed. Employing network meta-analysis, a comparison involving four post-procedural TR categories (improved, no improvement, worsened, and no change) was executed. Subsequently, these categories were amalgamated into two groups (less TR after TAVR and same or greater TR after TAVR), and a standard meta-analysis was conducted. Kaplan-Meier curves depicting long-term all-cause mortality were reconstructed utilizing individual patient data derived from the studies.ResultsA systematic review identified seven non-randomized studies encapsulating 698 patients. Network meta-analysis revealed that improved TR after TAVR correlated with significantly lower long-term all-cause mortality compared to the remaining cohorts. Similarly, pooled all-cause mortality of standard meta-analysis demonstrated significant reduction in patients whose TR was sub-baseline than those exhibiting same or greater TR after TAVR (HR [95% CI] = 0.43 [0.32-0.58], p < .01). The hazard ratio, derived from reconstructed time-to-event data, showed a lower long-term all-cause mortality in patients with less TR after TAVR relative to the other cohort (HR [95% CI] = 0.46 [0.32-0.67], p < .01).ConclusionThis meta-analysis revealed that improved TR after TAVR correlates with superior long-term survival. The benefits of simultaneous or staged intervention on the tricuspid valve in individuals undergoing TAVR warrant validation in future investigations.","PeriodicalId":519219,"journal":{"name":"Perfusion","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140833160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Left atrium volume and function changes during stress in patients with primary mitral regurgitation and preserved left ventricular ejection fraction 原发性二尖瓣反流和左心室射血分数保留患者在应激时左心房容积和功能的变化

Perfusion Pub Date : 2024-04-30 DOI: 10.1177/02676591241251441

Rūta Dirsienė, Rugilė Martinaitytė, Eglė Tamulėnaitė, Aistė Montvilaitė, Dainius Karčiauskas, Eglė Ereminienė, Justina Jolanta Vaškelytė

{"title":"Left atrium volume and function changes during stress in patients with primary mitral regurgitation and preserved left ventricular ejection fraction","authors":"Rūta Dirsienė, Rugilė Martinaitytė, Eglė Tamulėnaitė, Aistė Montvilaitė, Dainius Karčiauskas, Eglė Ereminienė, Justina Jolanta Vaškelytė","doi":"10.1177/02676591241251441","DOIUrl":"https://doi.org/10.1177/02676591241251441","url":null,"abstract":"IntroductionPatients with primary mitral regurgitation (MR) usually remain asymptomatic for a long time due to compensatory mechanisms and an adequate treatment could be delayed. Stress echocardiography and speckle-tracking analysis could help to evaluate impaired left atrium (LA) function before the manifestation of clinically significant myocardial changes in asymptomatic patients with primary MR and preserved left ventricular (LV) ejection fraction (EF).MethodsThis study prospectively enrolled 91 patients with preserved LV EF (≥60%) at rest, of which 60 patients had moderate-to-severe MR and 31 were healthy controls. Rest and stress (bicycle ergometry) echocardiography and speckle-tracking offline analysis were performed.ResultsIn MR group LA volume indices were higher at rest and during stress, while LA reservoir, conduit, and contractile fractions were decreased ( p < .005). LA deformation parameters at rest were similar in both groups. During maximum stress LA conduit, contractile fractions and reservoir strain were lower ( p < .05) in patients with MR. Indices of LA volume were related to SPAP at rest and during stress. Higher NT–proBNP concentrations was associated with higher LA volume indices, decreased contractile and reservoir functions during peak stress ( p < .05). LA volume indices, LA EF, and filling index at rest could predict exercise-induced pulmonary hypertension (EIPH) ( p < .05).ConclusionsIn patients with primary MR and preserved LV EF, LA parameters are related to SPAP and NT-pro-BNP concentration. LA volume indices, LA EF and LA filling index are predictors of EIPH.","PeriodicalId":519219,"journal":{"name":"Perfusion","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140833395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Extracorporeal membrane oxygenation (ECMO) assisted huge mediastinal tumor resection combined with superior vena cava replacement: A case report and literature review 体外膜肺氧合（ECMO）辅助巨大纵隔肿瘤切除术联合上腔静脉置换术：病例报告和文献综述

Perfusion Pub Date : 2024-04-29 DOI: 10.1177/02676591241251443

Jia Yu, Bin Liu, Ronghua Zhou

引用次数: 0