FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2896049100> ?p ?o ?g. }

• W2896049100 endingPage "e152" @default.
• W2896049100 startingPage "e151" @default.
• W2896049100 abstract "This report describes a simple way to deal with time-consuming adhesions and cannula handling in patients with a paracorporeal assist device who are undergoing heart transplantation. By connecting the extrathoracic lines to the heart-lung machine, chest reentry becomes a straightforward issue. This report describes a simple way to deal with time-consuming adhesions and cannula handling in patients with a paracorporeal assist device who are undergoing heart transplantation. By connecting the extrathoracic lines to the heart-lung machine, chest reentry becomes a straightforward issue. Heart transplantation in a patient with a paracorporeal assist device can be cumbersome, particularly with a biventricular Berlin Heart assist device (Berlin Heart, Berlin, Germany) [1Almond C.S. Morales D.L. Blackstone E.H. et al.Berlin Heart EXCOR pediatric ventricular assist device for bridge to heart transplantation in US children.Circulation. 2013; 127: 1702-1711Crossref PubMed Scopus (357) Google Scholar, 2Mascio C.E. The use of ventricular assist device support in children: the state of the art.Artif Organs. 2015; 39: 14-20Crossref PubMed Scopus (36) Google Scholar, 3Kirklin J.R. Advances in mechanical assist devices and artificial hearts for children.Curr Opin Pediatr. 2015; 27: 597-603Crossref PubMed Scopus (20) Google Scholar, 4Maeda K. Rosenthal D.N. Reinhartz O. Ventricular assist devices for neonates and infants.Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2018; 21: 9-14Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar]. Not only is resternotomy risky, but also the cannulas in front of the heart obstruct the surgical site and increase the operating time for further dissection. Peripheral cannulation can partially solve the problem, depending on whether vessel patency is reliable. A simple and effective alternative has been successfully adopted by our group. The lines from the pump machine are connected to the cannulas of the Berlin Heart device and thus achieve “paracorporeal-extracorporeal” circulation. The chest is opened in an empty beating heart, and dissection proceeds until new standard intrathoracic cannulas are inserted and bypass is switched to regular extracorporeal circulation. The patient is prepared and draped as usual, leaving the four cannulas thoroughly rinsed while the assist device is covered (Fig 1). Lines are displayed on the field, with a short bridge (by means of two “Y” connectors) that is double-clamped at both ends (Fig 2). After heparin administration, the assist device is stopped, and all four lines are clamped and disconnected. The main line from the pump is severed; its venous end is connected to the right atrial (cannula, and its arterial end is connected to the aortic cannula (Fig 2). Extracorporeal circulation is then started. Similarly, both pulmonary artery and apical left ventricular lines can be connected to pump suckers. Paracorporeal extracorporeal circulation is running with an empty decompressed heart (and ventilation can be stopped) before approaching resternotomy.Fig 2Cannulas displayed before reentering the chest. Bypass is started by connecting the venous line (V) to the right atrial cannula, and the arterial line (A) to the aortic cannula. Pump suckers are connected to the pulmonary artery and left ventricular cannulas. A bridge is formed, clamped at both ends (yellow circles), and ready to be switched from the paracorporeal cannulas to the intrathoracic pump.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Redo operations, usually cumbersome, become fairly simple. Inasmuch three cannulas are in the way (right atrial, aortic, pulmonary artery), dissection in a decompressed heart is accomplished with less risk of damaging surrounding structures (as in a peripheral femoral approach [5Lamelas J. Williams R.F. Mawad M. LaPietra A. Complications associated with femoral cannulation during minimally invasive cardiac surgery.Ann Thorac Surg. 2017; 103: 1927-1932Abstract Full Text Full Text PDF PubMed Scopus (49) Google Scholar]). On reaching target temperatures, pursestring sutures in the aorta and in both venae cavae are fashioned for placement of new cannulas, to switch to conventional intrathoracic extracorporeal circulation. At this stage, the bridge line between clamps (Fig 2) is severed, and both ends are connected to the arterial and venous cannulas, respectively. In this way, a smooth shift from paracorporeal to intrathoracic circulation is achieved without the need to stop the pump machine. The former assist device cannulas, once disconnected from the paracorporeal run, are sequentially removed, and dissection proceeds as usual. Our group has performed 52 heart transplant operations in patients with congenital heart defects in the last 5 years. Six of 17 patients with a Berlin Heart device had biventricular device assistance. The last 2 patients who had biventricular assist devices underwent heart transplantation according to this new strategy. Risk was lower than anticipated, and time was saved. This finding is particularly interesting in such a demanding scenario as heart transplantation (where coordination and time constraints can be overwhelming). Peripheral cannulation [5Lamelas J. Williams R.F. Mawad M. LaPietra A. Complications associated with femoral cannulation during minimally invasive cardiac surgery.Ann Thorac Surg. 2017; 103: 1927-1932Abstract Full Text Full Text PDF PubMed Scopus (49) Google Scholar] is helpful in redo operations. Often, the groin vessels of patients with congenital heart disease are not suitable because of previous catheterization laboratory studies. Alternative access sites (eg, jugular, axillary) have been advocated, but they are time consuming and not always reliable. Interestingly, paracorporeal cannulas from an assist device are “staring at you and ready to be helpful” just before they are removed. Our approach is a simple and expeditious way to begin bypass, thus paving the way for a safer and quicker resternotomy." @default.
• W2896049100 created "2018-10-26" @default.
• W2896049100 creator A5034754979 @default.
• W2896049100 creator A5042592134 @default.
• W2896049100 creator A5079425317 @default.
• W2896049100 creator A5086136249 @default.
• W2896049100 date "2019-02-01" @default.
• W2896049100 modified "2023-10-18" @default.
• W2896049100 title "Paracorporeal Connection to Heart-Lung Machine in Transplant Surgery With the Berlin Heart Ventricular Assist Device" @default.
• W2896049100 cites W1905518616 @default.
• W2896049100 cites W2028806761 @default.
• W2896049100 cites W2171896373 @default.
• W2896049100 cites W2563904451 @default.
• W2896049100 cites W2787479393 @default.
• W2896049100 doi "https://doi.org/10.1016/j.athoracsur.2018.08.082" @default.
• W2896049100 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/30365957" @default.
• W2896049100 hasPublicationYear "2019" @default.
• W2896049100 type Work @default.
• W2896049100 sameAs 2896049100 @default.
• W2896049100 citedByCount "1" @default.
• W2896049100 countsByYear W28960491002022 @default.
• W2896049100 crossrefType "journal-article" @default.
• W2896049100 hasAuthorship W2896049100A5034754979 @default.
• W2896049100 hasAuthorship W2896049100A5042592134 @default.
• W2896049100 hasAuthorship W2896049100A5079425317 @default.
• W2896049100 hasAuthorship W2896049100A5086136249 @default.
• W2896049100 hasBestOaLocation W28960491001 @default.
• W2896049100 hasConcept C126322002 @default.
• W2896049100 hasConcept C141071460 @default.
• W2896049100 hasConcept C164705383 @default.
• W2896049100 hasConcept C17744445 @default.
• W2896049100 hasConcept C199539241 @default.
• W2896049100 hasConcept C2778074680 @default.
• W2896049100 hasConcept C2778198053 @default.
• W2896049100 hasConcept C2778774980 @default.
• W2896049100 hasConcept C2778849806 @default.
• W2896049100 hasConcept C2779473830 @default.
• W2896049100 hasConcept C2781448352 @default.
• W2896049100 hasConcept C2911091166 @default.
• W2896049100 hasConcept C71924100 @default.
• W2896049100 hasConcept C83867959 @default.
• W2896049100 hasConceptScore W2896049100C126322002 @default.
• W2896049100 hasConceptScore W2896049100C141071460 @default.
• W2896049100 hasConceptScore W2896049100C164705383 @default.
• W2896049100 hasConceptScore W2896049100C17744445 @default.
• W2896049100 hasConceptScore W2896049100C199539241 @default.
• W2896049100 hasConceptScore W2896049100C2778074680 @default.
• W2896049100 hasConceptScore W2896049100C2778198053 @default.
• W2896049100 hasConceptScore W2896049100C2778774980 @default.
• W2896049100 hasConceptScore W2896049100C2778849806 @default.
• W2896049100 hasConceptScore W2896049100C2779473830 @default.
• W2896049100 hasConceptScore W2896049100C2781448352 @default.
• W2896049100 hasConceptScore W2896049100C2911091166 @default.
• W2896049100 hasConceptScore W2896049100C71924100 @default.
• W2896049100 hasConceptScore W2896049100C83867959 @default.
• W2896049100 hasIssue "2" @default.
• W2896049100 hasLocation W28960491001 @default.
• W2896049100 hasLocation W28960491002 @default.
• W2896049100 hasOpenAccess W2896049100 @default.
• W2896049100 hasPrimaryLocation W28960491001 @default.
• W2896049100 hasRelatedWork W1974528976 @default.
• W2896049100 hasRelatedWork W1999487197 @default.
• W2896049100 hasRelatedWork W2006698805 @default.
• W2896049100 hasRelatedWork W2106439281 @default.
• W2896049100 hasRelatedWork W2124543267 @default.
• W2896049100 hasRelatedWork W2125804349 @default.
• W2896049100 hasRelatedWork W2892480731 @default.
• W2896049100 hasRelatedWork W2896049100 @default.
• W2896049100 hasRelatedWork W2920043851 @default.
• W2896049100 hasRelatedWork W627787277 @default.
• W2896049100 hasVolume "107" @default.
• W2896049100 isParatext "false" @default.
• W2896049100 isRetracted "false" @default.
• W2896049100 magId "2896049100" @default.
• W2896049100 workType "article" @default.