A dual-vent left heart deairing technique markedly reduces carotid artery microemboli
Background. Cerebral embolization, mainly bubbles, follows aortic declamping in left heart valve operations. Embolization is not prevented by conventional left heart deairing methods. We have validated a “dual-vent” deairing technique, which uses high-flow left ventricular and aortic venting from th...
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| Veröffentlicht in: | The Annals of thoracic surgery 1998-09, Vol.66 (3), p.785-791 |
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| creator | Milsom, F.Paget Mitchell, Simon J |
| description | Background. Cerebral embolization, mainly bubbles, follows aortic declamping in left heart valve operations. Embolization is not prevented by conventional left heart deairing methods. We have validated a “dual-vent” deairing technique, which uses high-flow left ventricular and aortic venting from the working heart into the cardiopulmonary bypass venous line before aortic declamping.
Methods. After left heart valve replacement, intraoperative color-flow Doppler echocardiography was used to monitor the right common carotid embolic activity in 58 consecutive patients who underwent conventional deairing (group 1), 14 consecutive patients who underwent deairing by the dual-vent technique (group 2), and 4 patients who received nonvented coronary artery bypass grafting who did not require deairing (group 3).
Results. The median emboli count recorded after aortic declamping was 1,647 (range, 342 to 6,852) and 101 (range, 0 to 865) in the group 1 and 2 patients, respectively (
p < 0.0001). The efficacy of the dual-vent technique improved throughout the series: in the last 7 patients, the emboli counts often approached the very low levels seen in group 3 patients (median, 8; range, 1 to 16).
Conclusions. Cerebral embolization after aortic declamping in left heart valve operations was significantly reduced by this dual-vent deairing technique. |
| doi_str_mv | 10.1016/S0003-4975(98)00572-4 |
| format | Article |
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Methods. After left heart valve replacement, intraoperative color-flow Doppler echocardiography was used to monitor the right common carotid embolic activity in 58 consecutive patients who underwent conventional deairing (group 1), 14 consecutive patients who underwent deairing by the dual-vent technique (group 2), and 4 patients who received nonvented coronary artery bypass grafting who did not require deairing (group 3).
Results. The median emboli count recorded after aortic declamping was 1,647 (range, 342 to 6,852) and 101 (range, 0 to 865) in the group 1 and 2 patients, respectively (
p < 0.0001). The efficacy of the dual-vent technique improved throughout the series: in the last 7 patients, the emboli counts often approached the very low levels seen in group 3 patients (median, 8; range, 1 to 16).
Conclusions. Cerebral embolization after aortic declamping in left heart valve operations was significantly reduced by this dual-vent deairing technique.</description><identifier>ISSN: 0003-4975</identifier><identifier>EISSN: 1552-6259</identifier><identifier>DOI: 10.1016/S0003-4975(98)00572-4</identifier><identifier>PMID: 9768931</identifier><identifier>CODEN: ATHSAK</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Anesthesia ; Anesthesia depending on type of surgery ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Cardiac Surgical Procedures - adverse effects ; Cardiac Surgical Procedures - methods ; Cardiopulmonary Bypass ; Carotid Artery Thrombosis - etiology ; Carotid Artery Thrombosis - prevention & control ; Echocardiography, Doppler, Color ; Female ; Heart Valve Diseases - surgery ; Humans ; Male ; Medical sciences ; Middle Aged ; Prospective Studies ; Thoracic and cardiovascular surgery. Cardiopulmonary bypass</subject><ispartof>The Annals of thoracic surgery, 1998-09, Vol.66 (3), p.785-791</ispartof><rights>1998 The Society of Thoracic Surgeons</rights><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c424t-66b39f244c46f9c50003710bb4fd99c3f972959611b4de5ba60d4bb411b084de3</citedby><cites>FETCH-LOGICAL-c424t-66b39f244c46f9c50003710bb4fd99c3f972959611b4de5ba60d4bb411b084de3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0003497598005724$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>309,310,314,776,780,785,786,3537,23909,23910,25118,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2412316$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9768931$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Milsom, F.Paget</creatorcontrib><creatorcontrib>Mitchell, Simon J</creatorcontrib><title>A dual-vent left heart deairing technique markedly reduces carotid artery microemboli</title><title>The Annals of thoracic surgery</title><addtitle>Ann Thorac Surg</addtitle><description>Background. Cerebral embolization, mainly bubbles, follows aortic declamping in left heart valve operations. Embolization is not prevented by conventional left heart deairing methods. We have validated a “dual-vent” deairing technique, which uses high-flow left ventricular and aortic venting from the working heart into the cardiopulmonary bypass venous line before aortic declamping.
Methods. After left heart valve replacement, intraoperative color-flow Doppler echocardiography was used to monitor the right common carotid embolic activity in 58 consecutive patients who underwent conventional deairing (group 1), 14 consecutive patients who underwent deairing by the dual-vent technique (group 2), and 4 patients who received nonvented coronary artery bypass grafting who did not require deairing (group 3).
Results. The median emboli count recorded after aortic declamping was 1,647 (range, 342 to 6,852) and 101 (range, 0 to 865) in the group 1 and 2 patients, respectively (
p < 0.0001). The efficacy of the dual-vent technique improved throughout the series: in the last 7 patients, the emboli counts often approached the very low levels seen in group 3 patients (median, 8; range, 1 to 16).
Conclusions. Cerebral embolization after aortic declamping in left heart valve operations was significantly reduced by this dual-vent deairing technique.</description><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia</subject><subject>Anesthesia depending on type of surgery</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>Cardiac Surgical Procedures - methods</subject><subject>Cardiopulmonary Bypass</subject><subject>Carotid Artery Thrombosis - etiology</subject><subject>Carotid Artery Thrombosis - prevention & control</subject><subject>Echocardiography, Doppler, Color</subject><subject>Female</subject><subject>Heart Valve Diseases - surgery</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Thoracic and cardiovascular surgery. Cardiopulmonary bypass</subject><issn>0003-4975</issn><issn>1552-6259</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkEtPAyEYRYnR1Pr4CU1YGKOLUWCAGVamaXwlJi7UNWHgG0XnoTDTpP9eaptuXZGPe4DLQWhGyRUlVF6_EELyjKtCXKjykhBRsIzvoSkVgmWSCbWPpjvkEB3F-JlGluIJmqhCliqnU_Q2x240TbaEbsAN1AP-ABMG7MD44Lt3PID96PzPCLg14Qtcs8IB3GghYmtCP3iHEw9hhVtvQw9t1Tf-BB3Upolwul2P0dvd7eviIXt6vn9czJ8yyxkfMimrXNWMc8tlraxY1y0oqSpeO6VsXquCKaEkpRV3ICojieMpTTMp005-jM43936HPlWMg259tNA0poN-jFoqxUvCSQLFBkwVYwxQ6-_g04dWmhK91qn_dOq1K61K_adT83Rutn1grFpwu1Nbfyk_2-YmWtPUwXTWxx3GOGU5lQm72WCQZCw9BB2th86C8wHsoF3v_ynyCzIrkWc</recordid><startdate>19980901</startdate><enddate>19980901</enddate><creator>Milsom, F.Paget</creator><creator>Mitchell, Simon J</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19980901</creationdate><title>A dual-vent left heart deairing technique markedly reduces carotid artery microemboli</title><author>Milsom, F.Paget ; Mitchell, Simon J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c424t-66b39f244c46f9c50003710bb4fd99c3f972959611b4de5ba60d4bb411b084de3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anesthesia</topic><topic>Anesthesia depending on type of surgery</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Cardiac Surgical Procedures - adverse effects</topic><topic>Cardiac Surgical Procedures - methods</topic><topic>Cardiopulmonary Bypass</topic><topic>Carotid Artery Thrombosis - etiology</topic><topic>Carotid Artery Thrombosis - prevention & control</topic><topic>Echocardiography, Doppler, Color</topic><topic>Female</topic><topic>Heart Valve Diseases - surgery</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Thoracic and cardiovascular surgery. Cardiopulmonary bypass</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Milsom, F.Paget</creatorcontrib><creatorcontrib>Mitchell, Simon J</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Annals of thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Milsom, F.Paget</au><au>Mitchell, Simon J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A dual-vent left heart deairing technique markedly reduces carotid artery microemboli</atitle><jtitle>The Annals of thoracic surgery</jtitle><addtitle>Ann Thorac Surg</addtitle><date>1998-09-01</date><risdate>1998</risdate><volume>66</volume><issue>3</issue><spage>785</spage><epage>791</epage><pages>785-791</pages><issn>0003-4975</issn><eissn>1552-6259</eissn><coden>ATHSAK</coden><abstract>Background. Cerebral embolization, mainly bubbles, follows aortic declamping in left heart valve operations. Embolization is not prevented by conventional left heart deairing methods. We have validated a “dual-vent” deairing technique, which uses high-flow left ventricular and aortic venting from the working heart into the cardiopulmonary bypass venous line before aortic declamping.
Methods. After left heart valve replacement, intraoperative color-flow Doppler echocardiography was used to monitor the right common carotid embolic activity in 58 consecutive patients who underwent conventional deairing (group 1), 14 consecutive patients who underwent deairing by the dual-vent technique (group 2), and 4 patients who received nonvented coronary artery bypass grafting who did not require deairing (group 3).
Results. The median emboli count recorded after aortic declamping was 1,647 (range, 342 to 6,852) and 101 (range, 0 to 865) in the group 1 and 2 patients, respectively (
p < 0.0001). The efficacy of the dual-vent technique improved throughout the series: in the last 7 patients, the emboli counts often approached the very low levels seen in group 3 patients (median, 8; range, 1 to 16).
Conclusions. Cerebral embolization after aortic declamping in left heart valve operations was significantly reduced by this dual-vent deairing technique.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>9768931</pmid><doi>10.1016/S0003-4975(98)00572-4</doi><tpages>7</tpages></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Adult Aged Anesthesia Anesthesia depending on type of surgery Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Cardiac Surgical Procedures - adverse effects Cardiac Surgical Procedures - methods Cardiopulmonary Bypass Carotid Artery Thrombosis - etiology Carotid Artery Thrombosis - prevention & control Echocardiography, Doppler, Color Female Heart Valve Diseases - surgery Humans Male Medical sciences Middle Aged Prospective Studies Thoracic and cardiovascular surgery. Cardiopulmonary bypass |
| title | A dual-vent left heart deairing technique markedly reduces carotid artery microemboli |
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