Cerebral microembolization during off-pump coronary artery bypass surgery with the Symmetry aortic connector device
| Autor: | Erik Fosse, Runar Lundblad, Jacob Bergsland, Jan L. Svennevig, Steinar Halvorsen, Rainer Brucher, Mona Skjelland, Kjell Arne Rein, Per Snorre Lingaas, David Russell |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Ultrasonography Doppler Transcranial medicine.medical_treatment Coronary Artery Bypass Off-Pump Aorta Thoracic Anastomosis law.invention law Internal medicine medicine.artery medicine Cardiopulmonary bypass Humans Embolization Aged Off-pump coronary artery bypass Aged 80 and over Aorta Intraoperative Care business.industry Equipment Design Middle Aged Surgery Transcranial Doppler medicine.anatomical_structure Intracranial Embolism Bypass surgery cardiovascular system Cardiology Female business Cardiology and Cardiovascular Medicine Artery |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 130(6):1581-1585 |
| ISSN: | 0022-5223 |
| DOI: | 10.1016/j.jtcvs.2005.08.015 |
| Popis: | Objective The use of aortic connector systems for proximal vein grafts in off-pump coronary artery bypass grafting might minimize aortic manipulation by eliminating the need for partial aortic clamping. The objective of this study was to asses whether use of a Symmetry connector (St Jude Medical, Inc, St Paul, Minn) reduced intraoperative cerebral embolization. Methods Thirty-two consecutive patients underwent off-pump coronary artery bypass grafting. Sixteen patients received at least one mechanical proximal vein graft anastomosis with a Symmetry aortic connector system. Sixteen patients representing the control group underwent operations with standard suturing techniques using partial aortic clamping. During surgical intervention, all patients were monitored continuously with multifrequency transcranial Doppler scanning, which detected and differentiated cerebral emboli. Results There were significantly more cerebral emboli in the Symmetry group (median, 36) compared with the control group (median, 11; P = .027). This was due to a higher number of gaseous emboli in the Symmetry group than in the control group (median, 27 vs 8; P = .014), whereas there was no significant difference regarding the number of solid emboli (median, 7 vs 3; P = .139). Conclusion Use of a Symmetry connector system during proximal vein graft anastomosis increased the number of emboli to the brain compared with a standard technique in coronary bypass surgery without cardiopulmonary bypass. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|