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Soichiro Kitamura - One of the best experts on this subject based on the ideXlab platform.
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evolving arch surgery using integrated antegrade selective cerebral Perfusion impact of axillary Artery Perfusion
The Journal of Thoracic and Cardiovascular Surgery, 2008Co-Authors: Hitoshi Ogino, Hiroaki Sasaki, Kenji Minatoya, Hitoshi Matsuda, Hiroshi Tanaka, Hirotaka Watanuki, Motomi Ando, Soichiro KitamuraAbstract:Objective The study objective was to determine the impact of integrated antegrade selective cerebral Perfusion with right axillary Artery Perfusion during arch surgery. Methods All surgeries were performed through a median sternotomy. Direct cannulation of the right axillary Artery in the axilla was used for cardiopulmonary bypass and antegrade selective cerebral Perfusion under hypothermia. In addition, ascending aortic or femoral Artery Perfusion was used. The clinical records of 531 patients (median age, 72 years) between 1999 and 2006 were reviewed, of whom 137 patients (25.8%) underwent emergency surgery. There were 164 dissecting and 367 nondissecting aortic lesions. The surgeries included total arch replacement in 431 patients, partial arch replacement in 9 patients, and hemiarch replacement in 91 patients. Results The early mortality rate was 4.0% (2.3% of 30-day mortality and 1.7% of in-hospital mortality). The incidence of permanent neurologic dysfunction was 2.9% in all (3.3% in total arch replacement and 1.0% in hemiarch or partial arch replacement). The incidence of temporary dysfunction was 9.9% in all (10.6% in total arch replacement and 7.0% in hemiarch or partial arch replacement). Multivariate analysis demonstrated that the risk factors for early mortality were chronic renal failure, ruptured nondissecting aneurysm, and prolonged surgery. The midterm survival was 87.2% ± 1.7% at 3 years and 80.5% ± 2.6% at 5 years. Conclusion Right axillary Artery Perfusion is an advantageous adjunct to cardiopulmonary bypass and antegrade selective cerebral Perfusion in arch surgery.
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total arch replacement using antegrade selective cerebral Perfusion with right axillary Artery Perfusion
European Journal of Cardio-Thoracic Surgery, 2003Co-Authors: Satoshi Numata, Hitoshi Ogino, Hiroaki Sasaki, Motomi Ando, Yuji Hanafusa, Mituhiro Hirata, Soichiro KitamuraAbstract:OBJECTIVE: Right axillary Artery (AxA) Perfusion, which can prevent cerebral embolism caused by retrograde Perfusion via the femoral Artery (FA), was used for selective cerebral Perfusion (SCP) as well as cardiopulmonary bypass (CPB) in aortic arch repair. We review the outcome of aortic arch surgery using SCP with right AxA Perfusion to clarify its efficacy. METHOD: Between 1998 and 2002, 120 patients underwent aortic arch repair using SCP with right AxA Perfusion. The mean age was 69+/-10 years. Aneurysms were atherosclerotic in 79, dissecting in 32, and others in nine patients. Twenty of them (16.7%) required emergency surgery. CPB was initiated with right AxA and FA Perfusion, and following SCP was established using right AxA and left common carotid Artery Perfusion. RESULTS: With right AxA Perfusion, hospital mortality was 5.8%. Multivariate analysis showed only ruptured aneurysm was an independent determinant for hospital mortality. Permanent neurological dysfunction developed in one patient (0.8%), while seven (5.8%) suffered from temporary one. In univariate analysis, SCP time, stenosis of the carotid arteries, past history of cerebrovascular events, and atherosclerotic aneurysm were not related to temporary neurological deficits CONCLUSION: Right AxA Perfusion in conjunction with SCP is a safe and useful alternative for brain protection in total arch replacement.
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Total arch replacement using antegrade selective cerebral Perfusion with right axillary Artery Perfusion
European Journal of Cardio-Thoracic Surgery, 2003Co-Authors: Satoshi Numata, Hitoshi Ogino, Hiroaki Sasaki, Motomi Ando, Yuji Hanafusa, Mituhiro Hirata, Soichiro KitamuraAbstract:Objective: Right axillary Artery (AxA) Perfusion, which can prevent cerebral embolism caused by retrograde Perfusion via the femoral Artery (FA), was used for selective cerebral Perfusion (SCP) as well as cardiopulmonary bypass (CPB) in aortic arch repair. We review the outcome of aortic arch surgery using SCP with right AxA Perfusion to clarify its efficacy. Method: Between 1998 and 2002, 120 patients underwent aortic arch repair using SCP with right AxA Perfusion. The mean age was 69 ^ 10 years. Aneurysms were atherosclerotic in 79, dissecting in 32, and others in nine patients. Twenty of them (16.7%) required emergency surgery. CPB was initiated with right AxA and FA Perfusion, and following SCP was established using right AxA and left common carotid Artery Perfusion. Results: With right AxA Perfusion, hospital mortality was 5.8%. Multivariate analysis showed only ruptured aneurysm was an independent determinant for hospital mortality. Permanent neurological dysfunction developed in one patient (0.8%), while seven (5.8%) suffered from temporary one. In univariate analysis, SCP time, stenosis of the carotid arteries, past history of cerebrovascular events, and atherosclerotic aneurysm were not related to temporary neurological deficits Conclusion: Right AxA Perfusion in conjunction with SCP is a safe and useful alternative for brain protection in total arch replacement. q 2003 Elsevier Science B.V. All rights reserved.
Hitoshi Ogino - One of the best experts on this subject based on the ideXlab platform.
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evolving arch surgery using integrated antegrade selective cerebral Perfusion impact of axillary Artery Perfusion
The Journal of Thoracic and Cardiovascular Surgery, 2008Co-Authors: Hitoshi Ogino, Hiroaki Sasaki, Kenji Minatoya, Hitoshi Matsuda, Hiroshi Tanaka, Hirotaka Watanuki, Motomi Ando, Soichiro KitamuraAbstract:Objective The study objective was to determine the impact of integrated antegrade selective cerebral Perfusion with right axillary Artery Perfusion during arch surgery. Methods All surgeries were performed through a median sternotomy. Direct cannulation of the right axillary Artery in the axilla was used for cardiopulmonary bypass and antegrade selective cerebral Perfusion under hypothermia. In addition, ascending aortic or femoral Artery Perfusion was used. The clinical records of 531 patients (median age, 72 years) between 1999 and 2006 were reviewed, of whom 137 patients (25.8%) underwent emergency surgery. There were 164 dissecting and 367 nondissecting aortic lesions. The surgeries included total arch replacement in 431 patients, partial arch replacement in 9 patients, and hemiarch replacement in 91 patients. Results The early mortality rate was 4.0% (2.3% of 30-day mortality and 1.7% of in-hospital mortality). The incidence of permanent neurologic dysfunction was 2.9% in all (3.3% in total arch replacement and 1.0% in hemiarch or partial arch replacement). The incidence of temporary dysfunction was 9.9% in all (10.6% in total arch replacement and 7.0% in hemiarch or partial arch replacement). Multivariate analysis demonstrated that the risk factors for early mortality were chronic renal failure, ruptured nondissecting aneurysm, and prolonged surgery. The midterm survival was 87.2% ± 1.7% at 3 years and 80.5% ± 2.6% at 5 years. Conclusion Right axillary Artery Perfusion is an advantageous adjunct to cardiopulmonary bypass and antegrade selective cerebral Perfusion in arch surgery.
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total arch replacement using antegrade selective cerebral Perfusion with right axillary Artery Perfusion
European Journal of Cardio-Thoracic Surgery, 2003Co-Authors: Satoshi Numata, Hitoshi Ogino, Hiroaki Sasaki, Motomi Ando, Yuji Hanafusa, Mituhiro Hirata, Soichiro KitamuraAbstract:OBJECTIVE: Right axillary Artery (AxA) Perfusion, which can prevent cerebral embolism caused by retrograde Perfusion via the femoral Artery (FA), was used for selective cerebral Perfusion (SCP) as well as cardiopulmonary bypass (CPB) in aortic arch repair. We review the outcome of aortic arch surgery using SCP with right AxA Perfusion to clarify its efficacy. METHOD: Between 1998 and 2002, 120 patients underwent aortic arch repair using SCP with right AxA Perfusion. The mean age was 69+/-10 years. Aneurysms were atherosclerotic in 79, dissecting in 32, and others in nine patients. Twenty of them (16.7%) required emergency surgery. CPB was initiated with right AxA and FA Perfusion, and following SCP was established using right AxA and left common carotid Artery Perfusion. RESULTS: With right AxA Perfusion, hospital mortality was 5.8%. Multivariate analysis showed only ruptured aneurysm was an independent determinant for hospital mortality. Permanent neurological dysfunction developed in one patient (0.8%), while seven (5.8%) suffered from temporary one. In univariate analysis, SCP time, stenosis of the carotid arteries, past history of cerebrovascular events, and atherosclerotic aneurysm were not related to temporary neurological deficits CONCLUSION: Right AxA Perfusion in conjunction with SCP is a safe and useful alternative for brain protection in total arch replacement.
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Total arch replacement using antegrade selective cerebral Perfusion with right axillary Artery Perfusion
European Journal of Cardio-Thoracic Surgery, 2003Co-Authors: Satoshi Numata, Hitoshi Ogino, Hiroaki Sasaki, Motomi Ando, Yuji Hanafusa, Mituhiro Hirata, Soichiro KitamuraAbstract:Objective: Right axillary Artery (AxA) Perfusion, which can prevent cerebral embolism caused by retrograde Perfusion via the femoral Artery (FA), was used for selective cerebral Perfusion (SCP) as well as cardiopulmonary bypass (CPB) in aortic arch repair. We review the outcome of aortic arch surgery using SCP with right AxA Perfusion to clarify its efficacy. Method: Between 1998 and 2002, 120 patients underwent aortic arch repair using SCP with right AxA Perfusion. The mean age was 69 ^ 10 years. Aneurysms were atherosclerotic in 79, dissecting in 32, and others in nine patients. Twenty of them (16.7%) required emergency surgery. CPB was initiated with right AxA and FA Perfusion, and following SCP was established using right AxA and left common carotid Artery Perfusion. Results: With right AxA Perfusion, hospital mortality was 5.8%. Multivariate analysis showed only ruptured aneurysm was an independent determinant for hospital mortality. Permanent neurological dysfunction developed in one patient (0.8%), while seven (5.8%) suffered from temporary one. In univariate analysis, SCP time, stenosis of the carotid arteries, past history of cerebrovascular events, and atherosclerotic aneurysm were not related to temporary neurological deficits Conclusion: Right AxA Perfusion in conjunction with SCP is a safe and useful alternative for brain protection in total arch replacement. q 2003 Elsevier Science B.V. All rights reserved.
Surya M Nauli - One of the best experts on this subject based on the ideXlab platform.
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Real-time vascular mechanosensation through ex vivo Artery Perfusion
Biological Procedures Online, 2014Co-Authors: Rahul M Prasad, Wissam A Aboualaiwi, Surya M NauliAbstract:Background Cell-based Perfusion studies have provided great insight into fluid-sensing mechanisms, such as primary cilia in the renal and vascular systems. However, the intrinsic limitations of in vitro cell culture, such as the inability to reflect cellular organization within tissues, has distanced observed paradigms from possible clinical developments. Here we describe a protocol that applies ex vivo Artery Perfusion and calcium imaging to observe real-time cellular responses to fluid-shear stress. Results Through our ex vivo Artery Perfusion method, we were able to simulate physiological flow and initiate distinct fluid shear stress mechanosensory responses, as well as induced acetylcholine responses in mouse aortic tissue. The observed calcium profiles confirm results found through previous in vitro cell culture experiments. The overall procedure, including dissection, sample preparation and Perfusion, takes around 3 hours to complete. Conclusion Through our unique method, we are able to induce laminar flow within intact mouse aortic tissue and illicit subsequent cellular responses. This method of ex vivo Artery Perfusion provides the opportunity to bridge the novel findings of in vitro studies with subsequent physiological models of fluid-shear stress mechanosensation in vascular tissues.
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Real-time vascular mechanosensation through ex vivo Artery Perfusion
Biological Procedures Online, 2014Co-Authors: Rahul M Prasad, Wissam A Aboualaiwi, Xingjian Jin, Surya M NauliAbstract:Background Cell-based Perfusion studies have provided great insight into fluid-sensing mechanisms, such as primary cilia in the renal and vascular systems. However, the intrinsic limitations of in vitro cell culture, such as the inability to reflect cellular organization within tissues, has distanced observed paradigms from possible clinical developments. Here we describe a protocol that applies ex vivo Artery Perfusion and calcium imaging to observe real-time cellular responses to fluid-shear stress.
Hiroaki Sasaki - One of the best experts on this subject based on the ideXlab platform.
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evolving arch surgery using integrated antegrade selective cerebral Perfusion impact of axillary Artery Perfusion
The Journal of Thoracic and Cardiovascular Surgery, 2008Co-Authors: Hitoshi Ogino, Hiroaki Sasaki, Kenji Minatoya, Hitoshi Matsuda, Hiroshi Tanaka, Hirotaka Watanuki, Motomi Ando, Soichiro KitamuraAbstract:Objective The study objective was to determine the impact of integrated antegrade selective cerebral Perfusion with right axillary Artery Perfusion during arch surgery. Methods All surgeries were performed through a median sternotomy. Direct cannulation of the right axillary Artery in the axilla was used for cardiopulmonary bypass and antegrade selective cerebral Perfusion under hypothermia. In addition, ascending aortic or femoral Artery Perfusion was used. The clinical records of 531 patients (median age, 72 years) between 1999 and 2006 were reviewed, of whom 137 patients (25.8%) underwent emergency surgery. There were 164 dissecting and 367 nondissecting aortic lesions. The surgeries included total arch replacement in 431 patients, partial arch replacement in 9 patients, and hemiarch replacement in 91 patients. Results The early mortality rate was 4.0% (2.3% of 30-day mortality and 1.7% of in-hospital mortality). The incidence of permanent neurologic dysfunction was 2.9% in all (3.3% in total arch replacement and 1.0% in hemiarch or partial arch replacement). The incidence of temporary dysfunction was 9.9% in all (10.6% in total arch replacement and 7.0% in hemiarch or partial arch replacement). Multivariate analysis demonstrated that the risk factors for early mortality were chronic renal failure, ruptured nondissecting aneurysm, and prolonged surgery. The midterm survival was 87.2% ± 1.7% at 3 years and 80.5% ± 2.6% at 5 years. Conclusion Right axillary Artery Perfusion is an advantageous adjunct to cardiopulmonary bypass and antegrade selective cerebral Perfusion in arch surgery.
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total arch replacement using antegrade selective cerebral Perfusion with right axillary Artery Perfusion
European Journal of Cardio-Thoracic Surgery, 2003Co-Authors: Satoshi Numata, Hitoshi Ogino, Hiroaki Sasaki, Motomi Ando, Yuji Hanafusa, Mituhiro Hirata, Soichiro KitamuraAbstract:OBJECTIVE: Right axillary Artery (AxA) Perfusion, which can prevent cerebral embolism caused by retrograde Perfusion via the femoral Artery (FA), was used for selective cerebral Perfusion (SCP) as well as cardiopulmonary bypass (CPB) in aortic arch repair. We review the outcome of aortic arch surgery using SCP with right AxA Perfusion to clarify its efficacy. METHOD: Between 1998 and 2002, 120 patients underwent aortic arch repair using SCP with right AxA Perfusion. The mean age was 69+/-10 years. Aneurysms were atherosclerotic in 79, dissecting in 32, and others in nine patients. Twenty of them (16.7%) required emergency surgery. CPB was initiated with right AxA and FA Perfusion, and following SCP was established using right AxA and left common carotid Artery Perfusion. RESULTS: With right AxA Perfusion, hospital mortality was 5.8%. Multivariate analysis showed only ruptured aneurysm was an independent determinant for hospital mortality. Permanent neurological dysfunction developed in one patient (0.8%), while seven (5.8%) suffered from temporary one. In univariate analysis, SCP time, stenosis of the carotid arteries, past history of cerebrovascular events, and atherosclerotic aneurysm were not related to temporary neurological deficits CONCLUSION: Right AxA Perfusion in conjunction with SCP is a safe and useful alternative for brain protection in total arch replacement.
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Total arch replacement using antegrade selective cerebral Perfusion with right axillary Artery Perfusion
European Journal of Cardio-Thoracic Surgery, 2003Co-Authors: Satoshi Numata, Hitoshi Ogino, Hiroaki Sasaki, Motomi Ando, Yuji Hanafusa, Mituhiro Hirata, Soichiro KitamuraAbstract:Objective: Right axillary Artery (AxA) Perfusion, which can prevent cerebral embolism caused by retrograde Perfusion via the femoral Artery (FA), was used for selective cerebral Perfusion (SCP) as well as cardiopulmonary bypass (CPB) in aortic arch repair. We review the outcome of aortic arch surgery using SCP with right AxA Perfusion to clarify its efficacy. Method: Between 1998 and 2002, 120 patients underwent aortic arch repair using SCP with right AxA Perfusion. The mean age was 69 ^ 10 years. Aneurysms were atherosclerotic in 79, dissecting in 32, and others in nine patients. Twenty of them (16.7%) required emergency surgery. CPB was initiated with right AxA and FA Perfusion, and following SCP was established using right AxA and left common carotid Artery Perfusion. Results: With right AxA Perfusion, hospital mortality was 5.8%. Multivariate analysis showed only ruptured aneurysm was an independent determinant for hospital mortality. Permanent neurological dysfunction developed in one patient (0.8%), while seven (5.8%) suffered from temporary one. In univariate analysis, SCP time, stenosis of the carotid arteries, past history of cerebrovascular events, and atherosclerotic aneurysm were not related to temporary neurological deficits Conclusion: Right AxA Perfusion in conjunction with SCP is a safe and useful alternative for brain protection in total arch replacement. q 2003 Elsevier Science B.V. All rights reserved.
Motomi Ando - One of the best experts on this subject based on the ideXlab platform.
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evolving arch surgery using integrated antegrade selective cerebral Perfusion impact of axillary Artery Perfusion
The Journal of Thoracic and Cardiovascular Surgery, 2008Co-Authors: Hitoshi Ogino, Hiroaki Sasaki, Kenji Minatoya, Hitoshi Matsuda, Hiroshi Tanaka, Hirotaka Watanuki, Motomi Ando, Soichiro KitamuraAbstract:Objective The study objective was to determine the impact of integrated antegrade selective cerebral Perfusion with right axillary Artery Perfusion during arch surgery. Methods All surgeries were performed through a median sternotomy. Direct cannulation of the right axillary Artery in the axilla was used for cardiopulmonary bypass and antegrade selective cerebral Perfusion under hypothermia. In addition, ascending aortic or femoral Artery Perfusion was used. The clinical records of 531 patients (median age, 72 years) between 1999 and 2006 were reviewed, of whom 137 patients (25.8%) underwent emergency surgery. There were 164 dissecting and 367 nondissecting aortic lesions. The surgeries included total arch replacement in 431 patients, partial arch replacement in 9 patients, and hemiarch replacement in 91 patients. Results The early mortality rate was 4.0% (2.3% of 30-day mortality and 1.7% of in-hospital mortality). The incidence of permanent neurologic dysfunction was 2.9% in all (3.3% in total arch replacement and 1.0% in hemiarch or partial arch replacement). The incidence of temporary dysfunction was 9.9% in all (10.6% in total arch replacement and 7.0% in hemiarch or partial arch replacement). Multivariate analysis demonstrated that the risk factors for early mortality were chronic renal failure, ruptured nondissecting aneurysm, and prolonged surgery. The midterm survival was 87.2% ± 1.7% at 3 years and 80.5% ± 2.6% at 5 years. Conclusion Right axillary Artery Perfusion is an advantageous adjunct to cardiopulmonary bypass and antegrade selective cerebral Perfusion in arch surgery.
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total arch replacement using antegrade selective cerebral Perfusion with right axillary Artery Perfusion
European Journal of Cardio-Thoracic Surgery, 2003Co-Authors: Satoshi Numata, Hitoshi Ogino, Hiroaki Sasaki, Motomi Ando, Yuji Hanafusa, Mituhiro Hirata, Soichiro KitamuraAbstract:OBJECTIVE: Right axillary Artery (AxA) Perfusion, which can prevent cerebral embolism caused by retrograde Perfusion via the femoral Artery (FA), was used for selective cerebral Perfusion (SCP) as well as cardiopulmonary bypass (CPB) in aortic arch repair. We review the outcome of aortic arch surgery using SCP with right AxA Perfusion to clarify its efficacy. METHOD: Between 1998 and 2002, 120 patients underwent aortic arch repair using SCP with right AxA Perfusion. The mean age was 69+/-10 years. Aneurysms were atherosclerotic in 79, dissecting in 32, and others in nine patients. Twenty of them (16.7%) required emergency surgery. CPB was initiated with right AxA and FA Perfusion, and following SCP was established using right AxA and left common carotid Artery Perfusion. RESULTS: With right AxA Perfusion, hospital mortality was 5.8%. Multivariate analysis showed only ruptured aneurysm was an independent determinant for hospital mortality. Permanent neurological dysfunction developed in one patient (0.8%), while seven (5.8%) suffered from temporary one. In univariate analysis, SCP time, stenosis of the carotid arteries, past history of cerebrovascular events, and atherosclerotic aneurysm were not related to temporary neurological deficits CONCLUSION: Right AxA Perfusion in conjunction with SCP is a safe and useful alternative for brain protection in total arch replacement.
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Total arch replacement using antegrade selective cerebral Perfusion with right axillary Artery Perfusion
European Journal of Cardio-Thoracic Surgery, 2003Co-Authors: Satoshi Numata, Hitoshi Ogino, Hiroaki Sasaki, Motomi Ando, Yuji Hanafusa, Mituhiro Hirata, Soichiro KitamuraAbstract:Objective: Right axillary Artery (AxA) Perfusion, which can prevent cerebral embolism caused by retrograde Perfusion via the femoral Artery (FA), was used for selective cerebral Perfusion (SCP) as well as cardiopulmonary bypass (CPB) in aortic arch repair. We review the outcome of aortic arch surgery using SCP with right AxA Perfusion to clarify its efficacy. Method: Between 1998 and 2002, 120 patients underwent aortic arch repair using SCP with right AxA Perfusion. The mean age was 69 ^ 10 years. Aneurysms were atherosclerotic in 79, dissecting in 32, and others in nine patients. Twenty of them (16.7%) required emergency surgery. CPB was initiated with right AxA and FA Perfusion, and following SCP was established using right AxA and left common carotid Artery Perfusion. Results: With right AxA Perfusion, hospital mortality was 5.8%. Multivariate analysis showed only ruptured aneurysm was an independent determinant for hospital mortality. Permanent neurological dysfunction developed in one patient (0.8%), while seven (5.8%) suffered from temporary one. In univariate analysis, SCP time, stenosis of the carotid arteries, past history of cerebrovascular events, and atherosclerotic aneurysm were not related to temporary neurological deficits Conclusion: Right AxA Perfusion in conjunction with SCP is a safe and useful alternative for brain protection in total arch replacement. q 2003 Elsevier Science B.V. All rights reserved.
