Straight Deep Hypothermic Arrest: Experience in 394 Patients Supports Its Effectiveness as a Sole Means of Brain Preservation

Gega, Arjet; Rizzo, John A.; Johnson, Michele H.; Tranquilli, Maryann; Farkas, Emily A.; Elefteriades, John A.

doi:10.1016/j.athoracsur.2007.04.107

Cited by 176 publications

(125 citation statements)

References 22 publications

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“…To protect organs from ischemic damage, surgery is usually performed during deep hypothermia. Deep hypothermic circulatory arrest or low-flow CPB has long been practiced in the repair of congenital heart disease in neonates, and of aneurysms of the thoracic aorta and giant intracranial aneurysms in adult patients (Mahle et al, 2000;Gega et al, 2007;Levati et al, 2007;Tabbutt et al, 2008). Although the protective potential of deep hypothermia is unquestionable, little is known about the mechanisms through which it protects organs or how to maximize its efficacy.…”

Section: Introductionmentioning

confidence: 99%

Deep Hypothermia Markedly Activates the Small Ubiquitin-Like Modifier Conjugation Pathway; Implications for the Fate of Cells Exposed to Transient Deep Hypothermic Cardiopulmonary Bypass

Yang

Mackensen

et al. 2009

J Cereb Blood Flow Metab

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Various cardiovascular operations are performed during conditions of deep hypothermic circulatory arrest. Here we investigated the effects of deep hypothermia on the small ubiquitin-like modifier (SUMO) conjugation pathway using a clinically relevant animal model of deep hypothermic cardiopulmonary bypass (DHCPB). Deep hypothermic cardiopulmonary bypass induced a marked activation of the SUMO conjugation pathway and triggered a nuclear translocation of SUMO2/3-conjugated proteins. Furthermore, DHCBP significantly modified gene expression. Activation of the SUMO conjugation pathway is believed to protect neurons from damage caused by low blood flow. This pathway may, therefore, play a key role in defining the outcome of cells exposed to DHCPB.

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Section: Introductionmentioning

confidence: 99%

Deep Hypothermia Markedly Activates the Small Ubiquitin-Like Modifier Conjugation Pathway; Implications for the Fate of Cells Exposed to Transient Deep Hypothermic Cardiopulmonary Bypass

Yang

Mackensen

et al. 2009

J Cereb Blood Flow Metab

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“…For instance, recently, the Yale group has published a report with a large cohort of patients (17). Nevertheless, it seems that, presently, the use of profound hypothermia as the only mode of cerebral protection mostly belongs to history and must only be used in exceptional circumstances when nothing else is possible.…”

Section: The Cerebral Protectionmentioning

confidence: 99%

Open repair techniques in the aortic arch are still superior

Bachet¹

2018

Ann. Cardiothorac. Surg.

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Conventional arch replacement can be carried out in a great majority of patients. Hybrid procedures are often as invasive and technically difficult as conventional ones. Moreover, their immediate results are, in many reported experiences, not better and their long-term results less favourable than the ones observed with conventional methods. So, yes, the open conventional arch replacement is still "the gold standard".

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“…Performing a thoracotomy and placing the patient on circulatory arrest is associated with some risk [7]; however, these risks were weighed against the potential injury of the patent grafts or pseudoaneurysm. We believed that our approach was best, allowing for prevention of rupture and keeping the patent grafts intact.…”

Section: Commentmentioning

confidence: 99%

“…The first reported bypass grafting for an aberrant left coronary artery was done in 1977 using a saphenous vein bypass from the aorta to the left main coronary artery [6]. The internal mammary artery has been favored for CABG in children because of superior patency rates as compared with saphenous vein grafts and its ability to grow with the child [7].…”

Section: Commentmentioning

confidence: 99%

Coronary Steal Syndrome After Coronary Artery Bypass for Anomalous Aortic Origin of a Coronary Artery

Youdelman

Pelletier

Mesia

et al. 2009

The Annals of Thoracic Surgery

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Straight Deep Hypothermic Arrest: Experience in 394 Patients Supports Its Effectiveness as a Sole Means of Brain Preservation

Cited by 176 publications

References 22 publications

Deep Hypothermia Markedly Activates the Small Ubiquitin-Like Modifier Conjugation Pathway; Implications for the Fate of Cells Exposed to Transient Deep Hypothermic Cardiopulmonary Bypass

Deep Hypothermia Markedly Activates the Small Ubiquitin-Like Modifier Conjugation Pathway; Implications for the Fate of Cells Exposed to Transient Deep Hypothermic Cardiopulmonary Bypass

Open repair techniques in the aortic arch are still superior

Coronary Steal Syndrome After Coronary Artery Bypass for Anomalous Aortic Origin of a Coronary Artery

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