Current status of brain protection during surgery for congenital cardiac defect

Sakamoto, Takahiko

doi:10.1007/s11748-015-0606-z

Cited by 16 publications

(9 citation statements)

References 45 publications

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“…The significance of neurological complications in corrective cardiac surgeries has been highlighted for many years. [ 11 ] In our study, the overall frequency of acute neurological complications was 1.75% with seizures being the most frequent complications with a frequency of 1.4% which is similar to that reported by Menache et al ., but <9%–32% reported by earlier retrospective series. [ 3 5 12 ] This shows that as the intraoperative techniques are improving, neurological complications are decreasing.…”

Section: Discussionsupporting

confidence: 90%

Frequency and outcome of acute neurologic complications after congenital heart disease surgery

et al. 2017

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Objectives:To determine the frequency and immediate outcome of acute neurologic complications (ANCs) in children undergoing congenital heart surgery (CHS).Materials and Methods:In this retrospective study, all patients undergoing CHS at our hospital from January 2007 to June 2016 were included. Patients were followed up for the development of seizures, altered level of consciousness (ALOC), abnormal movements, and stroke. Results are presented as mean with standard deviation and frequency with percentages.Results:Of 2000 patients who underwent CHS at our center during the study, 35 patients (1.75%) developed ANC. Seizures occurred in 28 (80%), ALOC in 5 (14%), clinical stroke in 2, brain death in 6 patients. Antiepileptic drugs (AEDs) were started in 32 patients, of which 13 patients required more than one AED. Mean length of stay was 10 ± 7.36 days. Of 35 patients who developed ANC, 7 expired during the study.Conclusion:Neurological complications are scarce but significant morbidity after CHS at our center.

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Section: Discussionsupporting

confidence: 90%

Frequency and outcome of acute neurologic complications after congenital heart disease surgery

et al. 2017

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“…Exposure to neonatal surgery can put the immature brain at risk (104, 105). An increased risk of neurodevelopmental delay after neonatal surgery has indeed been reported (106, 107). Both the procedure as well as anesthetics can be harmful (108–110).…”

Section: Clinical Applicationmentioning

confidence: 99%

Monitoring Cerebral Oxygenation in Neonates: An Update

2017

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Cerebral oxygenation is not always reflected by systemic arterial oxygenation. Therefore, regional cerebral oxygen saturation (rScO2) monitoring with near-infrared spectroscopy (NIRS) is of added value in neonatal intensive care. rScO2 represents oxygen supply to the brain, while cerebral fractional tissue oxygen extraction, which is the ratio between rScO2 and systemic arterial oxygen saturation, reflects cerebral oxygen utilization. The balance between oxygen supply and utilization provides insight in neonatal cerebral (patho-)physiology. This review highlights the potential and limitations of cerebral oxygenation monitoring with NIRS in the neonatal intensive care unit.

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“…The STS with confined heparin (100 U/kg), was carried out without using CPB with an intention to reduce the morbidity associated with extra corporeal circulation. Eliminating CPB reduced the cost of the procedure substantially and saved the patient from its inherent complications [10]. .After procedure the enough time was prepared on behalf of the heart to compensate its chambers especially the right ventricle and left atrium and ensure endurable state for the main surgery.…”

Section: Discussionmentioning

confidence: 99%

A new palliative surgical technique for high risk Total anomalous pulmonary venous connection (Sarmast-Takriti shunt)

Sarmast

Takriti

2019

J Cardiothorac Surg

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Background Total Anomalous Pulmonary Venous Connection (TAPVC) is a rare heterogeneous condition That accounting for 1.5–3% of congenital heart diseases. It is characterized by failure of the Pulmonary Venous Confluence (PVC) to be directly connected to the left atrium in combination with a persistent splanchnic connection to the systemic venous circulation. The most critical status occurs when it is accompanied by pulmonary venous obstruction. Managing of this situation is very difficult and in fact, pulmonary venous obstruction is usually lethal. The real aim of this study is offering a new palliative surgical technique (Sarmast – Takriti Shunt) in order to alleviate the patient’s signs and symptoms until becomes ready for the main surgical correction. Case presentation The study included a 4–day old, low birth weight boy who suffered from Critical Obstructive Total Anomalous Pulmonary Venous Connection. The decision was made to perform the new palliative technique using Gore - Tex (ePTFE). Anastomosis was established without Cardiopulmonary Bypass (CPB) between Pulmonary Venous Confluence (PVC) and the left atrial appendage. Therefore the Sarmast – Takriti Shunt (STS) was taken place. Conclusion After completion of the procedure, the pressure gradient across the venous confluence and the Left innominate vein became zero. Cyanosis, agitation and feeding Problem subsided. Three days later, when he was discharged, arterial oxygen saturation had reached as high as 91%. After 7 months we perfomed the main correction.

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Current status of brain protection during surgery for congenital cardiac defect

Cited by 16 publications

References 45 publications

Frequency and outcome of acute neurologic complications after congenital heart disease surgery

Frequency and outcome of acute neurologic complications after congenital heart disease surgery

Monitoring Cerebral Oxygenation in Neonates: An Update

A new palliative surgical technique for high risk Total anomalous pulmonary venous connection (Sarmast-Takriti shunt)

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