Selective visceral and renal perfusion in thoracoabdominal aneurysm repair1

Abstract

Our experience suggests that selective visceral and renal perfusion has a protective effect on hepato-renal function during TAAA repair.

Intraoperative skeletal muscle ischemia contributes to risk of renal dysfunction following thoracoabdominal aortic repair☆☆☆

“…While no standard definition of post-TAAA renal dysfunction has become established in the literature, studies that define it in terms of increasing postoperative creatinine report rates of 10-40%, [1][2][3][4][5][6] while those that define it as requirement for new dialysis report rates in the 2-15% range [3,4,[6][7][8]. The only large multicenter report in the literature to date describes renal failure rates submitted by hospitals to Medicare as part of their billing data.…”

Aneurisma tóraco-abdominal inflamatório

“…Além disso, um dos indicadores pré-operatórios de mortalidade na cirurgia dos ATA é a creatinina acima de 1,5 mg/dl 10 , reforçando a necessidade de preservar a perfusão renal durante o pinçamento aórtico em pacientes com função renal anormal. Na literatura, ainda é controverso o uso de perfusão visceral em ATA IV, sendo que muitos autores têm bom resultado com essa técnica [15][16][17] , enquanto que outros apresentam os mesmos resultados com o clamp and go ou apenas perfusão de solução cristalói-de gelada [7][8][9]18 . Acreditamos que cada caso deve ser avaliado em particular, levando-se em consideração as dificuldades técnicas encontradas.…”

Enhanced removal of bilirubin on molecularly imprinted titania film

“…This can cause disorders in the metabolism of bilirubin and evoke various diseases [5][6][7]. Several techniques have been employed for the direct removal of bilirubin from plasma of patients suffering from hyperbilirubinemia such as haemoperfusion, haemodialysis, affinity membrane chromatography [8][9][10]. Among them, Haemoperfusion treatment, i.e., circulation of blood through an extracorporeal unit containing an adsorbent system for bilirubin, is the most promising technique at present [11,12].…”