Solid and gaseous cerebral microembolization during off-pump, on-pump, and open cardiac surgery procedures

Abu‐Omar, Yasir; Balacumaraswami, Lognathen; Pigott, David; Matthews, Paul M.; Taggart, David P.

doi:10.1016/j.jtcvs.2003.09.048

Cited by 135 publications

(94 citation statements)

References 23 publications

(10 reference statements)

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“…The formation and transport of bubbles inside the blood vessels can have exogenous origin, when air is injected in the blood stream, or endogenous origin when gas bubbles form inside the blood stream. Bubbles from exogenous origin include bubbles resulting from medical proceedings such as surgeries (Borger et al 2001, Abu-Omar et al 2004, hemodialysis (Bischel et al 1975) and gas embolotherapy (Samuel et al 2012). Bubbles from endogenous origin comprise the formation of bubbles by cavitation in heart valves (Deklunder et al 1998, Milo et al 2003 and when pressure decreases abruptly in scuba diving (Papadopoulou et al 2013), astronaut extra vehicular activities (Karlsson et al 2009) or in high altitude flight (Foster and Butler 2009).…”

Section: Introductionmentioning

confidence: 99%

Microbubble moving in blood flow in microchannels: effect on the cell-free layer and cell local concentration

Bento

Sousa

Yaginuma

et al. 2017

Biomed Microdevices

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Gas embolisms can hinder blood flow and lead to occlusion of the vessels and ischemia. Bubbles in microvessels circulate as tubular bubbles (Taylor bubbles) and can be trapped, blocking the normal flow of blood. To understand how Taylor bubbles flow in microcirculation, in particular, how bubbles disturb the blood flow at the scale of blood cells, experiments were performed in microchannels at a low Capillary number. Bubbles moving with a stream of in vitro blood were filmed with the help of a high-speed camera. Cell-free layers (CFLs) were observed downstream of the bubble, near the microchannel walls and along the centerline, and their thicknesses were quantified. Upstream to the bubble, the cell concentration is higher and CFLs are less clear. While just upstream of the bubble the maximum RBC concentration happens at positions closest to the wall, downstream the maximum is in an intermediate region between the centerline and the wall. Bubbles within microchannels promote complex spatio-temporal variations of the CFL thickness along the microchannel with significant relevance for local rheology and transport processes. The phenomenon is explained by the flow pattern characteristic of low Capillary number flows. Spatio-temporal variations of blood rheology may have an important role in bubble trapping and dislodging.

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Section: Introductionmentioning

confidence: 99%

Microbubble moving in blood flow in microchannels: effect on the cell-free layer and cell local concentration

Bento

Sousa

Yaginuma

et al. 2017

Biomed Microdevices

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show abstract

“…(19) off-pump, on-pump KABG ve açık kardiyak prosedür uygulanan hastalarda intraoperatif mikroembolinin sayısını ve doğasını karşılaştırmak için transkraniyal doppler ultrasonografi kullanmışlar ve on-pump KABG prosedürlerde offpump olanlarla karşılaştırıldığında mikroembolide 7 kat artış saptamıştır. Genel olarak en zararlı kabul edilen solid mikroembolinin oranı, off-pump grupta anlamlı olarak düşük saptanmıştır.…”

Section: Discussionunclassified

The Comparison of the Effects of the Off-Pump and Cardiopulmonary By-Pass Techniques Upon Postoperative Delirium at Elective Coronary By-Pass Greft Surgery

Yı́lmaz¹,

Aksun²,

Girgin³

et al. 2013

GKDA Derg

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“…The preferred way to protect myocardium is delivering of adequate cardioplegic solution to whole myocardium, and severe occlusion of the coronary arteries limit this delivery by the antegrade route [6]. Another important indicator of achieving favorable results of CABG is the surgical technique [7] or the direction of cardioplegia delivery [8]. Currently many cardiac surgeons construct the proximal veno-aortic anastomoses during a single period of aortic side biting.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Serum Myocardial Biomarkers Following Two Different Methods of Venoaortic Connection in Coronary Artery Bypass Grafting: A Randomized Clinical Trial

Jelodar

Zarrabi

Nazifi

et al. 2017

Zahedan J Res Med Sci

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Background: Myocardium will expose to excessive ischemia and reperfusion during post-cardiac surgery, hence the aim of this study was to investigate the cardioprotective effect of sequential partial aortic side biting technique for proximal veno-aortic anastomosis constructions in patients undergoing coronary artery bypass grafting (CABG). Methods: In this randomized clinical trial study, 60 consecutive patients who were diagnosed to suffering from triple vessel coronary artery diseases were selected. CABG patients were assigned randomly into two groups; the first group received sooner and gradual myocardial reperfusion one-by-one top end venous anastomosis to the aorta (sequential aortic side biting technique) (n = 30) and the second group undergo proximal anastomoses constructed during a single period of aortic side biting (single aortic side biting technique) (n = 30). The serum levels of myocardial damage biomarkers including creatine phosphokinase-MB (CPK-MB), Troponin I, glutathione peroxidase (GPX), superoxide dismutase (SOD), malondialdehyde (MDA) and catalase (CAT) were measured preoperatively, postoperatively and 24 h after operation. Independent t-tests was used to compare results between groups. Results: The level of all myocardial biomarkers increased after the operation. Those in study group had significantly lower levels of troponin I (P < 0.001), CPK-MB (P = 0.001), GPX (P = 0.007), SOD (P = 0.005), and CAT (P = 0.015), 24h after the operation when compared to control group. Only the serum level of CPK-MB was significantly lower in study group after the operation (P = 0.029) while the other markers were comparable. Conclusions: Sequential partial occluding aortic side biting technique associated with less myocardial damage and ischemiareperfusion injury compared to conventional single method in patients undergoing elective coronary grafting.

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Solid and gaseous cerebral microembolization during off-pump, on-pump, and open cardiac surgery procedures

Cited by 135 publications

References 23 publications

Microbubble moving in blood flow in microchannels: effect on the cell-free layer and cell local concentration

Microbubble moving in blood flow in microchannels: effect on the cell-free layer and cell local concentration

The Comparison of the Effects of the Off-Pump and Cardiopulmonary By-Pass Techniques Upon Postoperative Delirium at Elective Coronary By-Pass Greft Surgery

Comparison of Serum Myocardial Biomarkers Following Two Different Methods of Venoaortic Connection in Coronary Artery Bypass Grafting: A Randomized Clinical Trial

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