What does cross-clamping the aorta do?
During open aortic surgery, interrupting the blood flow through the aorta by applying a cross-clamp is often a key step to allow for surgical repair. As a consequence, ischemia is induced in parts of the body distal to the clamp site.
What is the most dramatic and consistent effect of aortic cross-clamping?
Arterial hypertension is the most dramatic and consistent component of the hemodynamic response to aortic cross-clamping. Most texts attribute this sign to a sudden increase in impedance to aortic flow and an increase in afterload.
Where is aortic cross-clamp placed?
Definition. Surgery on the descending aorta almost always involves the application of a cross-clamp so the surgeon is able to sew a graft to it. As a general rule, the more proximal the clamp is placed to the heart, the greater amount of stress it places on the heart.
What is aortic cross-clamp time?
In the majority of patients, 30–90 min of cross-clamp time was required. Less than 2% of patients required cross-clamp times greater than 120 min and these patients were excluded for the reasons noted above.
Why is cross-clamp time important?
Conclusion: Prolonged cross-clamp time significantly correlates with major post-operative morbidity and mortality in both low- and high-risk patients. This effect increases with increasing XCL time. Prior knowledge on this effect can help in preventing some of these complications.
What is cross-clamp fibrillation?
Cross-clamp fibrillation is a well established method of performing coronary grafting, but its clinical effect on the myocardium is unknown. We sought to measure these effects clinically using the Khuri Intramyocardial pH monitor.
What is the aortic arch?
The aortic arch is the top part of the main artery carrying blood away from the heart. Aortic arch syndrome refers to a group of signs and symptoms associated with structural problems in the arteries that branch off the aortic arch. The interior of the heart is composed of valves, chambers, and associated vessels.
What is a potential complication of cardiopulmonary bypass?
Other complications include oxygenator failure, pump malfunction, clotting in the circuit, tubing rupture, gas supply failure and electrical failure due to which hand cranking must be available at all times.
What is del Nido cardioplegia?
Del Nido cardioplegia was developed by Pedro Del Nido and his team at the University of Pittsburgh in 1990s. It has been used for pediatric cardiac surgery in Boston’s Children Hospital since 1994 and, since 2003, it has been successfully used for adult cardiac surgery as well [8].
What is bypass time in cardiac surgery?
Coronary bypass surgery generally takes between three and six hours and requires general anesthesia. The number of bypasses you need depends on where in your heart and how severe your blockages are.
What are the 3 branches of the aorta called?
The convexity of the aortic arch gives off three branches; the brachiocephalic trunk, the left common carotid artery and the left subclavian artery. Brachiocephalic trunk: also called the brachiocephalic artery, is the first and largest artery that branches off the aortic arch.
What complications can occur after bypass surgery?
Possible complications include:
- Bleeding.
- An irregular heart rhythm.
- Infections of the chest wound.
- Memory loss or trouble thinking clearly, which often improves within six to 12 months.
- Kidney problems.
- Stroke.
- Heart attack, if a blood clot breaks loose soon after surgery.
What is Microplegia?
Abstract. Background: Microplegia (whole blood cardioplegia with reduced volume) retains all the advantages of blood cardioplegia (such as superior oxygen-carrying capacity, better osmotic properties and antioxidant capability, etc.) without the potential disadvantages of hemodilution (such as myocardial edema).
What is the best exercise after bypass surgery?
Walking. This walking program will improve the fitness of your heart, lungs and muscles. All muscles must be built up slowly, and the heart is no exception. This walking program will gradually reintroduce your heart to exercise, starting with very short walking periods.
How is aortic arch syndrome diagnosed?
Diagnosis. It is difficult to diagnose aortic arch conditions early because symptoms typically emerge only once an artery has narrowed. To rule out any other diseases with similar symptoms, a physician will review a patient’s complete medical history and then perform a thorough physical exam.