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- Kastengren, M, et al.
(författare)
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Intraventricular Septal Echinococcosis
- 2017
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Ingår i: The Annals of thoracic surgery. - : Elsevier BV. - 1552-6259 .- 0003-4975. ; 104:1, s. E89-E89
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Tidskriftsartikel (refereegranskat)
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- Ma, K, et al.
(författare)
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Routine use of percutaneous femoral cannulation in minimally invasive cardiac surgery
- 2023
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Ingår i: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. - : Oxford University Press (OUP). - 1873-734X. ; 63:3
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVESLarge series of percutaneous femoral access for extracorporeal circulation in minimally invasive cardiac surgery (MICS) are scarcely reported.METHODSThis is a single-centre study describing the use of percutaneous femoral access in patients undergoing MICS via minithoracotomy. Femoral artery closure was performed with a plug-based closure device. To reduce the risk for vascular complications, intraoperative ultrasound assessment of correct deployment of the arterial closure device was done during the later period of the study.RESULTSDuring a 5-year period, 650 patients underwent percutaneous femoral cannulation and decannulation with device closure of the femoral artery puncture. Two hundred and seven patients (31.8%) were operated in the early phase of the experience (August 2017–August 2019), without the use of intraoperative ultrasound assessment of closure device deployment. During the later period of our experience (August 2019–September 2022), 443 patients (68.2%) were operated, of whom all underwent intraoperative ultrasound assessment of closure device deployment. Of the patients operated without intraoperative ultrasound assessment, 6 patients (2.9%) experienced vascular complications compared with none of the patients in whom intraoperative ultrasound-assessment was used (P < 0.001). In total, 15 patients (2.3%) underwent conversion to surgical cutdown owing to incomplete haemostasis or femoral artery stenosis/occlusion and the mechanism was intravascular deployment of the closure device in all 15 cases.CONCLUSIONSPercutaneous femoral access in MICS is safe and the need for surgical cutdown was infrequent. The risk for vascular complications is minimized with the use of intraoperative ultrasound assessment of the correct positioning of the vascular closure device.CLINICAL TRIAL REGISTRATION NUMBERhttp://www.clinicaltrials.gov; Unique identifier: NCT05462769.
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- Nyman, J, et al.
(författare)
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Does CO(2) flushing of the empty CPB circuit decrease the number of gaseous emboli in the prime?
- 2009
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Ingår i: Perfusion. - : SAGE Publications. - 1477-111X .- 0267-6591. ; 24:4, s. 249-255
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Tidskriftsartikel (refereegranskat)abstract
- Twenty (20) CPB-circuits were randomized to a CO2 group or a control group. In the CO 2 group, each circuit was flushed with CO2 (10L/min) at the top of the venous reservoir for 5 minutes, after which priming fluid was added without interruption of the CO2 inflow. Control group circuits were not flushed and contained air. A perfusionist, blinded to the study, started the pump (5L/min), ventilated the oxygenator (3L O2/min), and knocked on the oxygenator 20 times during the first and 14th minutes. Arterial line microemboli counts were registered with a Doppler for 15 minutes. In both groups, the median number of microemboli was highest during the first minute, 380.5 (288.75/422.25, 25th/75th percentile) counts in the control group versus 264.5 (171.75/422.25) counts in the CO 2 group (p=0.01). Throughout the experiment, the median microembolic count minute by minute in the CO2 group remained lower (p≤ 0 .004) than in the control group. Knocking on the reservoir (14th minute) increased the microemboli counts in both groups (p<0.01). The median values during the 15th minute were 15.5 and 0.5 in the control and the CO2 groups, respectively, which were 9% (15.5/173) and 0.5% (0.5/87), respectively, of the values registered after 14 minutes. In conclusion, CO 2 flushing of the empty circuit decreases the number of gaseous emboli in the prime compared with a conventional circuit that contains air before being primed with fluid. Knocking of the oxygenator releases gaseous emboli and the duration of re-circulating the circuit with prime influences the number of microemboli.
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- Svenarud, P
(författare)
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Carbon dioxide de-airing in cardiac surgery
- 2006
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Ingår i: ACTA ANAESTHESIOLOGICA SCANDINAVICA. - : Wiley. - 0001-5172 .- 1399-6576. ; 50:5, s. 629-630
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 50. |
- Svenarud, P, et al.
(författare)
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Clinical effects of different protamine doses after cardiopulmonary bypass
- 2002
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Ingår i: Asian cardiovascular & thoracic annals. - : SAGE Publications. - 0218-4923 .- 1816-5370. ; 10:2, s. 119-23
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Tidskriftsartikel (refereegranskat)abstract
- The optimal dose of protamine needed to reverse the anticoagulant effect of heparin after cardiopulmonary bypass is still not known. In this retrospective cohort study, we investigated 3 different dose regimes in 300 patients undergoing coronary artery bypass grafting. Group A patients (n = 100) were given protamine in the ratio of 1.3 mg to 1 mg heparin, group B patients (n = 100) were given 0.75 mg protamine to 1 mg heparin, and group C patients (n = 100) were given protamine in fractionated doses of 1 mg + 0.15 mg + 0.15 mg to 1 mg heparin. The groups were comparable in all major clinical and operative variables. The heparin dose was almost identical in the groups. The rate of red cell transfusion was significantly higher in group B than in the other groups. A similar but nonsignificant trend was observed in the incidence of resternotomy for postoperative bleeding, mediastinal drainage, and postoperative hemoglobin loss. The study demonstrates that a single bolus dose of 1.3 mg protamine to 1 mg heparin is safe and efficient for neutralizing heparin after cardiopulmonary bypass.
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