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Henry M Spotnitz - One of the best experts on this subject based on the ideXlab platform.
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Left ventricular pacing lead insertion via the coronary sinus Cardioplegia Cannula: a novel method for temporary biventricular pacing during reoperative cardiac surgery.
The Journal of Thoracic and Cardiovascular Surgery, 2010Co-Authors: Daniel Y. Wang, Rabin Gerrah, Alexander Rusanov, Vinay Yalamanchi, Santos E. Cabreriza, Henry M SpotnitzAbstract:Objective Temporary biventricular pacing to treat low output states after cardiac surgery is an active area of investigation. Reoperative cases are not studied due to adhesions, which preclude left ventricular mobilization to place epicardial pacing wires. In such patients, inserting a temporary left ventricular lead via the coronary sinus Cardioplegia Cannula may allow for biventricular pacing. We developed a novel technique for intraoperative left ventricular lead placement. Methods Eight domestic pigs underwent median sternotomy and pericardiotomy. Temporary pacing wires were sewn to the right atrium and right ventricle. Complete heart block was induced by ethanol ablation of the atrioventricular node. A 13-French retrograde Cardioplegia catheter was introduced via the right atrial free wall into the coronary sinus. A 6-French left ventricular pacing lead was inserted into the Cardioplegia catheter and advanced into the coronary sinus during biventricular pacing until left ventricular capture was detected by electrocardiogram and arterial pressure monitoring. Left ventricular capture success rate and electrical performance were recorded during five placement attempts. Results Left ventricular capture was achieved on 80% of insertion attempts. Left ventricular capture without diaphragmatic pacing was achieved in 7 pigs. Lead tip locations were mostly in lateral and posterior basal coronary vein branches. There were no arrhythmias, bleeding, or perforation associated with lead insertion. Conclusions Intraoperative biventricular pacing with a left ventricular pacing lead inserted via the coronary sinus Cardioplegia Cannula is feasible, using standard instrumentation and without requiring cardiac manipulation. This approach merits further study in patients undergoing reoperative cardiac surgery.
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Left ventricular pacing lead insertion via the coronary sinus Cardioplegia Cannula: A novel method for temporary biventricular pacing during reoperative cardiac surgery
Journal of The American College of Surgeons, 2010Co-Authors: Daniel Y. Wang, Rabin Gerrah, Alexander Rusanov, Vinay Yalamanchi, Santos E. Cabreriza, Henry M SpotnitzAbstract:Objective—Temporary biventricular pacing to treat low output states after cardiac surgery is an active area of investigation. Reoperative cases are not studied due to adhesions, which preclude left ventricular mobilization to place epicardial pacing wires. In such patients, inserting a temporary left ventricular lead via the coronary sinus Cardioplegia Cannula may allow for biventricular pacing. We developed a novel technique for intraoperative left ventricular lead placement. Methods—Eight domestic pigs underwent median sternotomy and pericardiotomy. Temporary pacing wires were sewn to the right atrium and right ventricle. Complete heart block was induced by ethanol ablation of the atrioventricular node. A 13 French retrograde Cardioplegia catheter was introduced via the right atrial free wall into the coronary sinus. A 6 French left ventricular pacing lead was inserted into the Cardioplegia catheter and advanced into the coronary sinus, during biventricular pacing, until left ventricular capture was detected by electrocardiogram and arterial pressure monitoring. Left ventricular capture success rate and electrical performance were recorded during five placement attempts. Results—Left ventricular capture was achieved on 80% of insertion attempts. Left ventricular capture without diaphragmatic pacing was achieved in seven pigs. Lead tip locations were mostly in lateral and posterior basal coronary vein branches. There were no arrhythmias, bleeding, or perforation associated with lead insertion. Conclusions—Intraoperative biventricular pacing with a left ventricular pacing lead inserted via the coronary sinus Cardioplegia Cannula is feasible, using standard instrumentation and without requiring cardiac manipulation. This approach merits further study in patients undergoing reoperative cardiac surgery. © 2010 The American Association For Thoracic Surgery. Published by Mosby, Inc. All rights reserved. Corresponding Author: Henry M. Spotnitz, M.D. Department of Surgery Columbia University Medical Center 622 West 168th Street Vanderbilt Clinic, 10th Floor, Room 1010 New York, NY, 10032 Telephone: 212-305-6191 Fax: 212-305-9724 hms2@columbia.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Disclosures: Dr. Spotnitz is the Principal Investigator on the National Institutes of Health RO1 Grant HL080152, “Biventricular Pacing After Cardiopulmonary Bypass.” He is also a member of the Scientific Advisory Board of Biophan Technologies, Inc. NIH Public Access Author Manuscript J Thorac Cardiovasc Surg. Author manuscript; available in PMC 2012 September 02. Published in final edited form as: J Thorac Cardiovasc Surg. 2011 July ; 142(1): 73–76. doi:10.1016/j.jtcvs.2010.08.028. N IH PA Athor M anscript N IH PA Athor M anscript N IH PA Athor M anscript
Friedrich W Mohr - One of the best experts on this subject based on the ideXlab platform.
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iatrogenic type a aortic dissection during cardiac procedures early and late outcome in 48 patients
European Journal of Cardio-Thoracic Surgery, 2012Co-Authors: Sergey Leontyev, Denis R Merk, Jochen Hahn, Joerg Seeburger, Jean Francois Legare, S. Lehmann, Michael A Borger, Friedrich W MohrAbstract:OBJECTIVE: Iatrogenic aortic dissection (IAD) is a rare complication of cardiac procedures. We herein describe our management and results of this complication. METHODS: A total of 55 279 patients underwent open heart surgery at our centre from 1995 to 2010, and 135 262 patients underwent cardiac catheterization over the same time period. We identified 48 patients from this cohort who underwent emergency surgery for IAD that occurred either during or shortly after cardiac surgery, or following cardiac catheterization. RESULTS: The incidence of IAD was 0.06% (n= 36) for cardiac surgical procedures and 0.01% (n= 12) for cardiac catheterization procedures. The mean patient age was 66 ± 14 years and 50% were female. Intraoperative IAD occurred during aortic Cannulation in 12 patients, insertion of the Cardioplegia Cannula in 7 patients, manipulation of the aortic crossclamp in 4 patients or during other events in 8 patients. IAD occurred early postcardiac surgery in 5 patients, and during cardiac catheterization in the remaining 12 patients. IAD was treated by emergent replacement of the ascending aorta and the aortic arch (when involved), as well as aortic root replacement or repair as indicated. Early mortality was 41.7: 35.5% for intraoperative IAD, 60.0% for postoperative IAD and 50.0% for cardiac catheterization-associated IAD (P= 0.5). Histological investigation revealed atherosclerosis in 61.2% of patients, cystic medial necrosis in 22.2%, aortitis in 2.8% and other pathologies in 13.8%. Follow-up was 100% complete with a 5-year survival of 40 ± 0.4%. CONCLUSION: IAD is a rare but dangerous complication of cardiac surgery and cardiac catheterization, and is frequently associated with pre-existing aortic pathology.
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iatrogenic type a aortic dissection during cardiac procedures early and late outcome in 48 patients
European Journal of Cardio-Thoracic Surgery, 2012Co-Authors: Sergey Leontyev, Denis R Merk, Jochen Hahn, Joerg Seeburger, Jean Francois Legare, S. Lehmann, Michael A Borger, Friedrich W MohrAbstract:OBJECTIVE: Iatrogenic aortic dissection (IAD) is a rare complication of cardiac procedures. We herein describe our management and results of this complication. METHODS: A total of 55 279 patients underwent open heart surgery at our centre from 1995 to 2010, and 135 262 patients underwent cardiac catheterization over the same time period. We identified 48 patients from this cohort who underwent emergency surgery for IAD that occurred either during or shortly after cardiac surgery, or following cardiac catheterization. RESULTS: The incidence of IAD was 0.06% (n= 36) for cardiac surgical procedures and 0.01% (n= 12) for cardiac catheterization procedures. The mean patient age was 66 ± 14 years and 50% were female. Intraoperative IAD occurred during aortic Cannulation in 12 patients, insertion of the Cardioplegia Cannula in 7 patients, manipulation of the aortic crossclamp in 4 patients or during other events in 8 patients. IAD occurred early postcardiac surgery in 5 patients, and during cardiac catheterization in the remaining 12 patients. IAD was treated by emergent replacement of the ascending aorta and the aortic arch (when involved), as well as aortic root replacement or repair as indicated. Early mortality was 41.7: 35.5% for intraoperative IAD, 60.0% for postoperative IAD and 50.0% for cardiac catheterization-associated IAD (P= 0.5). Histological investigation revealed atherosclerosis in 61.2% of patients, cystic medial necrosis in 22.2%, aortitis in 2.8% and other pathologies in 13.8%. Follow-up was 100% complete with a 5-year survival of 40 ± 0.4%. CONCLUSION: IAD is a rare but dangerous complication of cardiac surgery and cardiac catheterization, and is frequently associated with pre-existing aortic pathology.
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Iatrogenic type A aortic dissection during cardiac procedures: early and late outcome in 48 patients
2011Co-Authors: Sergey Leontyev, Denis R Merk, Jochen Hahn, Joerg Seeburger, Jean Francois Legare, S. Lehmann, Michael A Borger, Friedrich W MohrAbstract:OBJECTIVE: Iatrogenic aortic dissection (IAD) is a rare complication of cardiac procedures. We herein describe our management and results of this complication. METHODS: A total of 55 279 patients underwent open heart surgery at our centre from 1995 to 2010, and 135 262 patients underwent cardiac catheterization over the same time period. We identified 48 patients from this cohort who underwent emergency surgery for IAD that occurred either during or shortly after cardiac surgery, or following cardiac catheterization. RESULTS: The incidence of IAD was 0.06 % (n = 36) for cardiac surgical procedures and 0.01 % (n = 12) for cardiac catheterization proce-dures. The mean patient age was 66 ± 14 years and 50 % were female. Intraoperative IAD occurred during aortic Cannulation in 12 patients, insertion of the Cardioplegia Cannula in 7 patients, manipulation of the aortic crossclamp in 4 patients or during other events in 8 patients. IAD occurred early postcardiac surgery in 5 patients, and during cardiac catheterization in the remaining 12 patients. IAD was treated by emergent replacement of the ascending aorta and the aortic arch (when involved), as well as aortic root replacement or repair as indicated. Early mortality was 41.7: 35.5 % for intraoperative IAD, 60.0 % for postoperative IAD and 50.0 % for cardiac catheter-ization-associated IAD (P = 0.5). Histological investigation revealed atherosclerosis in 61.2 % of patients, cystic medial necrosis in 22.2%, aortitis in 2.8 % and other pathologies in 13.8%. Follow-up was 100 % complete with a 5-year survival of 40 ± 0.4%. CONCLUSION: IAD is a rare but dangerous complication of cardiac surgery and cardiac catheterization, and is frequently associate
Kenji Yamazaki - One of the best experts on this subject based on the ideXlab platform.
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Left atrial dissection related to retrograde Cardioplegia Cannula insertion
Heart and Vessels, 2016Co-Authors: Hiroyuki Tsukui, Shizuko Iwasa, Kenji YamazakiAbstract:Left atrial dissection (LAD) is a rare complication and is defined as a gap from the mitral or tricuspid annular area to the interatrial septum or left atrial wall. Because of its low incidence, this entity is not fully understood. LAD is related to mitral valve surgery as well as coronary artery disease, arrhythmia, trauma, and tumors, and occurs spontaneously. Transesophageal echocardiography is the most useful diagnostic modality for LAD, but multimodality investigation supports accurate diagnosis. We experienced a case of LAD related to retrograde Cardioplegia Cannula insertion which was treated successfully with internal drainage.
Daniel Y. Wang - One of the best experts on this subject based on the ideXlab platform.
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Left ventricular pacing lead insertion via the coronary sinus Cardioplegia Cannula: a novel method for temporary biventricular pacing during reoperative cardiac surgery.
The Journal of Thoracic and Cardiovascular Surgery, 2010Co-Authors: Daniel Y. Wang, Rabin Gerrah, Alexander Rusanov, Vinay Yalamanchi, Santos E. Cabreriza, Henry M SpotnitzAbstract:Objective Temporary biventricular pacing to treat low output states after cardiac surgery is an active area of investigation. Reoperative cases are not studied due to adhesions, which preclude left ventricular mobilization to place epicardial pacing wires. In such patients, inserting a temporary left ventricular lead via the coronary sinus Cardioplegia Cannula may allow for biventricular pacing. We developed a novel technique for intraoperative left ventricular lead placement. Methods Eight domestic pigs underwent median sternotomy and pericardiotomy. Temporary pacing wires were sewn to the right atrium and right ventricle. Complete heart block was induced by ethanol ablation of the atrioventricular node. A 13-French retrograde Cardioplegia catheter was introduced via the right atrial free wall into the coronary sinus. A 6-French left ventricular pacing lead was inserted into the Cardioplegia catheter and advanced into the coronary sinus during biventricular pacing until left ventricular capture was detected by electrocardiogram and arterial pressure monitoring. Left ventricular capture success rate and electrical performance were recorded during five placement attempts. Results Left ventricular capture was achieved on 80% of insertion attempts. Left ventricular capture without diaphragmatic pacing was achieved in 7 pigs. Lead tip locations were mostly in lateral and posterior basal coronary vein branches. There were no arrhythmias, bleeding, or perforation associated with lead insertion. Conclusions Intraoperative biventricular pacing with a left ventricular pacing lead inserted via the coronary sinus Cardioplegia Cannula is feasible, using standard instrumentation and without requiring cardiac manipulation. This approach merits further study in patients undergoing reoperative cardiac surgery.
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Left ventricular pacing lead insertion via the coronary sinus Cardioplegia Cannula: A novel method for temporary biventricular pacing during reoperative cardiac surgery
Journal of The American College of Surgeons, 2010Co-Authors: Daniel Y. Wang, Rabin Gerrah, Alexander Rusanov, Vinay Yalamanchi, Santos E. Cabreriza, Henry M SpotnitzAbstract:Objective—Temporary biventricular pacing to treat low output states after cardiac surgery is an active area of investigation. Reoperative cases are not studied due to adhesions, which preclude left ventricular mobilization to place epicardial pacing wires. In such patients, inserting a temporary left ventricular lead via the coronary sinus Cardioplegia Cannula may allow for biventricular pacing. We developed a novel technique for intraoperative left ventricular lead placement. Methods—Eight domestic pigs underwent median sternotomy and pericardiotomy. Temporary pacing wires were sewn to the right atrium and right ventricle. Complete heart block was induced by ethanol ablation of the atrioventricular node. A 13 French retrograde Cardioplegia catheter was introduced via the right atrial free wall into the coronary sinus. A 6 French left ventricular pacing lead was inserted into the Cardioplegia catheter and advanced into the coronary sinus, during biventricular pacing, until left ventricular capture was detected by electrocardiogram and arterial pressure monitoring. Left ventricular capture success rate and electrical performance were recorded during five placement attempts. Results—Left ventricular capture was achieved on 80% of insertion attempts. Left ventricular capture without diaphragmatic pacing was achieved in seven pigs. Lead tip locations were mostly in lateral and posterior basal coronary vein branches. There were no arrhythmias, bleeding, or perforation associated with lead insertion. Conclusions—Intraoperative biventricular pacing with a left ventricular pacing lead inserted via the coronary sinus Cardioplegia Cannula is feasible, using standard instrumentation and without requiring cardiac manipulation. This approach merits further study in patients undergoing reoperative cardiac surgery. © 2010 The American Association For Thoracic Surgery. Published by Mosby, Inc. All rights reserved. Corresponding Author: Henry M. Spotnitz, M.D. Department of Surgery Columbia University Medical Center 622 West 168th Street Vanderbilt Clinic, 10th Floor, Room 1010 New York, NY, 10032 Telephone: 212-305-6191 Fax: 212-305-9724 hms2@columbia.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Disclosures: Dr. Spotnitz is the Principal Investigator on the National Institutes of Health RO1 Grant HL080152, “Biventricular Pacing After Cardiopulmonary Bypass.” He is also a member of the Scientific Advisory Board of Biophan Technologies, Inc. NIH Public Access Author Manuscript J Thorac Cardiovasc Surg. Author manuscript; available in PMC 2012 September 02. Published in final edited form as: J Thorac Cardiovasc Surg. 2011 July ; 142(1): 73–76. doi:10.1016/j.jtcvs.2010.08.028. N IH PA Athor M anscript N IH PA Athor M anscript N IH PA Athor M anscript
Ramin Javan - One of the best experts on this subject based on the ideXlab platform.
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ascending aortic pseudoaneurysm after aortic valve replacement watch the tip of the Cardioplegia Cannula
The Journal of Thoracic and Cardiovascular Surgery, 2009Co-Authors: Abbas Emaminia, Ahmad Ali Amirghofran, Masih Shafa, Alireza Moaref, Ramin JavanAbstract:Ascending aortic pseudoaneurysms are rare and occur infrequently from anastomotic dehiscence of suture lines and Cannulation sites from previous aortic surgery. Open surgical approach is the management of choice but carries a high risk of pseudoaneurysm rupture at the time of sternotomy. We describe a case of ascending aortic pesudoaneurysm with the orifice located on the posterior wall of the aorta, which is caused by the tip of the Cardioplegia Cannula inserted during a previous cardiac operation.