Successful One-Stage Operative Resection of an Intravenous Leiomyomatosis Involving the Right-Sided Heart Chambers and Pulmonary Artery

2016 ◽  
Vol 19 (2) ◽  
pp. 064
Author(s):  
Rongjian Xu ◽  
Qi Miao ◽  
Xingrong Liu ◽  
Chaoji Zhang ◽  
Guotao Ma
Keyword(s):  
Cardiopulmonary Bypass ◽  
Pulmonary Artery ◽  
Unique Feature ◽  
Circulatory Arrest ◽  
Deep Hypothermic Circulatory Arrest ◽  
Intravenous Leiomyomatosis ◽  
Right Heart ◽  
One Stage ◽  
The Right

Intravenous leiomyomatosis (IVL) is a rare neoplastic disorder. It may extend into the right cardiac chambers, which are named after intracardiac leiomyomatosis (ICL). We describe a case of IVL extending into the right heart and pulmonary artery in a 46-year-old woman. The patient successfully underwent a one-stage operation under cardiopulmonary bypass (CPB) with deep hypothermic circulatory arrest. The patient fully recovered without major complications and did not exhibit any recurrence at the 9-month follow-up. The unique feature of this case is its involvement with the pulmonary artery, which is uncommon but potentially lethal.

Critical Cyanosis in a Neonate With Unusual Congenital Tricuspid Valve Lesion

2020 ◽  
Vol 11 (4) ◽  
pp. 504-506
Author(s):  
Ventsislav Boshnakov ◽  
Stojan D. Lazarov ◽  
Plamen Mitev ◽  
Ivaylo Mitev ◽  
George Konstantinov ◽  
...  
Keyword(s):  
Tricuspid Valve ◽  
Circulatory Arrest ◽  
Deep Hypothermic Circulatory Arrest ◽  
Normal Function ◽  
Foramen Ovale ◽  
Large Tumor ◽  
Birth Weight Neonate ◽  
The Right ◽  
Valve Lesion

We describe a case of a low birth weight neonate who presented on second day of life with progressive cyanosis and oxygen saturation of 60% by pulse oximetry. The echocardiography examination revealed a large tumor-like mass connected to the tricuspid valve, with severe obstruction of the right ventricular inflow and massive right-to-left shunt through the distended foramen ovale. A large vegetation-like lesion with calcifications was discovered intraoperatively and was debrided by shave excision technique under deep hypothermic circulatory arrest. Follow-up showed normal function of the tricuspid valve and preserved biventricular function.

Cardiac and Pericardial Echinococcosis: Report of 15 Cases

2007 ◽  
Vol 15 (4) ◽  
pp. 278-279 ◽  
Author(s):  
Vakeli Murat ◽  
Zhongxi Qian ◽  
Shuiyuan Guo ◽  
Jun Qiao
Keyword(s):  
Heart Failure ◽  
Developing Countries ◽  
Cardiopulmonary Bypass ◽  
Right Heart Failure ◽  
Right Atrial ◽  
Serologic Test ◽  
Right Heart ◽  
Late Death ◽  
The Right

Between 1978 and 2002, 15 patients (mean age, 23.0 ± 8.5 years) with cardiac and pericardial echinococcosis were treated surgically. The cysts were located in the right atrium in 3 patients, on the anterior myocardium in 7, and pericardially in 5. The 3 patients with right atrial cysts were operated on using cardiopulmonary bypass. There were 4 recurrences requiring re-operation after a mean of 12 months. All other patients received mebendazole treatment and exhibited no recurrence during follow-up. One late death due to chronic right heart failure occurred after 10 months of follow-up. The serologic test is an effective method of diagnosis in undeveloped and developing countries.

scholarly journals A one-stage approach to the treatment of intravenous leiomyomatosis extending to the right heart

2010 ◽  
Vol 52 (1) ◽  
pp. 212-215 ◽  
Author(s):  
Pietro Rispoli ◽  
Davide Santovito ◽  
Caterina Tallia ◽  
Gianfranco Varetto ◽  
Massimo Conforti ◽  
...  
Keyword(s):  
Intravenous Leiomyomatosis ◽  
Right Heart ◽  
One Stage ◽  
The Right

scholarly journals Foley catheter and deep hypothermic circulatory arrest to control bleeding in redo cardiac surgery

2004 ◽  
Vol 51 (3) ◽  
pp. 117-119
Author(s):  
Dusko Nezic ◽  
S. Borovic ◽  
Milan Cirkovic ◽  
Ljiljana Lausevic-Vuk ◽  
A. Kenkovski ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Circulatory Arrest ◽  
Foley Catheter ◽  
Deep Hypothermic Circulatory Arrest ◽  
Hypothermic Circulatory Arrest ◽  
The Right ◽  
Right Atria ◽  
Combined Technique ◽  
Uncontrolled Bleeding

Two cases with catastrophic hemorrhage in redo cardiac surgery are described. In the first one tearing of right ventricle with uncontrolled bleeding occurred during sternal reentry. In the second one, tearing of the right atria occurred while the patient was on cardiopulmonary bypass. In both cases we were able to control bleeding using Foley catheter, which enabled us to proceed to deep hypothermic circulatory arrest to repair heart chambers (due to dense adhesions it was impossible to m?nage it in any other way). We have found this combined technique to be extremely useful tool to control catastrophic hemorrhage during redo cardiac surgery.

A novel augmented venous-drainage model of cardiopulmonary bypass for deep hypothermic circulatory arrest without blood priming

Perfusion ◽  
2017 ◽  
Vol 33 (4) ◽  
pp. 297-302 ◽  
Author(s):  
Xuan Jiang ◽  
Tianxiang Gu ◽  
Yu Liu ◽  
Chun Wang ◽  
Enyi Shi ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Femoral Artery ◽  
Jugular Vein ◽  
Circulatory Arrest ◽  
Venous Drainage ◽  
Deep Hypothermic Circulatory Arrest ◽  
Hypothermic Circulatory Arrest ◽  
Blood Gas ◽  
Left Femoral Artery ◽  
The Right

Objective: Cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA) are commonly used in cardiac surgery. However, the mortality and morbidity are still high in practice. Developing novel protective stategies and elucidating the underlying mechanisms for the pathophysiological consequences of DHCA have been hampered because of the absence of a satisfactory recovery animal model. The aim of this study was to establish a novel and safe DHCA model without blood priming in rats to study the pathophysiology of potential complications. Methods: Ten adult male Sprague-Dawley rats (age, 14-16 weeks; weight, 200-300g) were used. The entire CPB circuit consisted of a modified reservoir, a custom-designed small-volume membrane oxygenator, a roller pump and a home-made heat exchanger, all of which were connected via silicon tubing. The volume of the priming solution was less than 10 ml. The right jugular vein, right carotid artery and left femoral artery were cannulated. The blood was drained from the right atrium through the right jugular vein and fed back to the rat via the left femoral artery. CPB was commenced at a full flow rate. The animals were cooled to a pericranial temperature of 18°C and then subjected to 45 minutes of DHCA with global ischemia. Circulatory arrest was followed by rewarming and over 60 minutes of reperfusion. CPB was terminated carefully. Blood in the circuit was centrifuged and slowly transfused to achieve optimal hematocrit. Blood gas and hemodynamic parameters were recorded at each time point before CPB, during CPB and after CPB. Results: All CPB and DHCA processes were achieved successfully. No rat died in our research. Blood gas analyses at different times were normal. Cardiac function and blood pressure were stable after the operation. The vital signs of all the rats were stable. Conclusion: The novel augmented venous-drainage CPB and DHCA model in rats could be established successfully without blood priming.

Do Standard Monitoring Sites Reflect True Brain Temperature When Profound Hypothermia Is Rapidly Induced and Reversed? 

1995 ◽  
Vol 82 (2) ◽  
pp. 344-351 ◽  
Author(s):  
Gilbert J. Stone ◽  
William L. Young ◽  
Craig R. Smith ◽  
Robert A. Solomon ◽  
Alvin Wald ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Pulmonary Artery ◽  
Brain Temperature ◽  
Circulatory Arrest ◽  
Deep Hypothermic Circulatory Arrest ◽  
Temperature Measurements ◽  
Large Temperature ◽  
Profound Hypothermia ◽  
Giant Cerebral Aneurysm ◽  
Mean Differences

Background Brain temperature is closely approximated by most body temperature measurements under normal anesthetic conditions. However, when thermal autoregulation is overridden, large temperature gradients may prevail. This study sought to determine which of the standard temperature monitoring sites best approximates brain temperature when deep hypothermia is rapidly induced and reversed during cardiopulmonary bypass. Methods Twenty-seven patients underwent cardiopulmonary bypass and deep hypothermic circulatory arrest in order for each to have a giant cerebral aneurysm surgically clipped. Brain temperatures were measured directly with a thermocouple embedded in the cerebral cortex. Eight other body temperatures were monitored simultaneously with less invasive sensors at standard sites. Results Brain temperature decreased from 32.6 +/- 1.4 degrees C (mean +/- SD) to 16.7 +/- 1.7 degrees C in 28 +/- 7 min, for an average cerebral cooling rate of 0.59 +/- 0.15 degrees C/min. Circulatory arrest lasted 24 +/- 15 min and was followed by 63 +/- 17 min of rewarming at 0.31 +/- 0.09 degrees C/min. None of the monitored sites tracked cerebral temperature well throughout the entire hypothermic period. During rapid temperature change, nasopharyngeal, esophageal, and pulmonary artery temperatures corresponded to brain temperature with smaller mean differences than did those of the tympanic membrane, bladder, rectum, axilla, and sole of the foot. At circulatory arrest, nasopharyngeal, esophageal, and pulmonary artery mean temperatures were within 1 degree C of brain temperature, even though individual patients frequently exhibited disparate values at those sites. Conclusions When profound hypothermia is rapidly induced and reversed, temperature measurements made at standard monitoring sites may not reflect cerebral temperature. Measurements from the nasopharynx, esophagus, and pulmonary artery tend to match brain temperature best but only with an array of data can one feel comfortable disregarding discordant readings.

Global and regional cerebral blood flow in neonatal piglets undergoing pulsatile cardiopulmonary bypass with continuous perfusion at 25°C and circulatory arrest at 18°C

Perfusion ◽  
2001 ◽  
Vol 16 (6) ◽  
pp. 503-510 ◽  
Author(s):  
Akif Ündar ◽  
Takafumi Masai ◽  
Shuang-Qiang Yang ◽  
Harald C Eichstaedt ◽  
Mary Claire McGarry ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Cardiopulmonary Bypass ◽  
Regional Cerebral Blood Flow ◽  
Negative Impact ◽  
Circulatory Arrest ◽  
Deep Hypothermic Circulatory Arrest ◽  
Regional Cerebral Blood ◽  
Neonatal Piglets ◽  
The Right

To investigate the influence of hypothermic cardiopulmonary bypass (HCPB) at 25°C and circulatory arrest at 18°C on the global and regional cerebral blood flow (CBF) during pulsatile perfusion, we performed the following studies in a neonatal piglet model. Using a pediatric physiologic pulsatile pump, we subjected six piglets to deep hypothermic circulatory arrest (DHCA) and six other piglets to HCPB. The DHCA group underwent hypothermia for 25 min, DHCA for 60min, cold reperfusion for 10 min, and rewarming for 40 min. The HCPB group underwent 15 min of cooling, followed by 60 min of HCPB, 10min of cold reperfusion, and 30 min of rewarming. The following variables remained constant in both groups: pump flow (150 ml/kg/min), pump rate (150 bpm), and stroke volume (1 ml/kg). During the 60-min aortic crossclamp period, the temperature was kept at 18°C for DHCA and at 25°C for HCPB. The global and regional CBF (ml/100g/min) was assessed with radiolabeled microspheres. The CBF was 48% lower during deep hypothermia at 18°C (before DHCA) than during hypothermia at 25°C (55.2± 14.3 ml/100 g/min vs 106.4±19.7 ml/100 g/min; p < 0.05). After rewarming, the global CBF was 45% lower in the DHCA group than in the HCPB group 48.3±18.1 ml/100 g/min vs (87±35.9 ml/100 g/min; p<0.05). Fifteen minutes after the termination of CPB, the global CBF was only 25% lower in the DHCA group than in the HCPB group (42.2±20.7 ml/100 g/min vs 56.4±25.8 ml/100 g/min; p=NS). In the right and left hemispheres, cerebellum, basal ganglia, and brain stem, blood flow resembled the global CBF. In conclusion, both HCPB and DHCA significantly decrease the regional and global CBF during CPB. Unlike HCPB, DHCA has a continued negative impact on the CBF after rewarming. However, 15 min after the end of CPB, there are no significant intergroup differences in the CBF.

Intravenous Leiomyomatosis Extending into the Right Ventricular Cavity: One-Stage Radical Operation Using Cardiopulmonary Bypass

Angiology ◽  
2000 ◽  
Vol 51 (6) ◽  
pp. 505-509 ◽  
Author(s):  
Hidetaka Wakiyama ◽  
Takaki Sugimoto ◽  
Keiji Ataka ◽  
Chojiro Yamashita ◽  
Yoshihiko Tsuji ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Right Ventricular ◽  
Intravenous Leiomyomatosis ◽  
Radical Operation ◽  
Ventricular Cavity ◽  
One Stage ◽  
The Right

Repair of Anomalous Origin of Right Coronary Artery from the Pulmonary Artery

2007 ◽  
Vol 15 (5) ◽  
pp. 418-421 ◽  
Author(s):  
Hong-Wei Guo ◽  
Jian-Ping Xu ◽  
Yun-Hu Song ◽  
Han-Song Sun ◽  
Xiang-Dong Shen ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Coronary Artery ◽  
Pulmonary Artery ◽  
Right Coronary Artery ◽  
Septal Defect ◽  
Anomalous Origin ◽  
Off Pump ◽  
Autologous Pericardial Patch ◽  
The Right

Anomalous origin of the right coronary artery from the pulmonary artery is a rare cardiac malformation. Between July 2002 and July 2005, we operated on 4 patients with this defect. There were 2 males and 2 females, aged from 18 months to 42 years. Three patients underwent direct re-implantation of the right coronary artery into the aorta, and one had an intrapulmonary tunnel repair (intrapulmonary artery baffle with an autologous pericardial patch for tunneling to the anomalous right coronary ostium). Cardiopulmonary bypass was used in 2 patients, and an off-pump technique in the other 2. One patient had an atrial septal defect that was closed with an Amplatzer septal occluder through the right atrium under transesophageal echocardiography, without cardiopulmonary bypass. All patients survived and recovered uneventfully. Follow-up ranged from 3 to 39 months (mean, 17 months). All patients were doing well and free from symptoms, with normal exercise tolerance. Surgical correction of anomalous right coronary artery shows good early and midterm results.

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