Controlled limb reperfusion in patients having cardiac operations

The Journal of Thoracic and Cardiovascular Surgery
F BeyersdorfG D Buckberg

Abstract

Severe limb ischemia in patients having cardiac operations may occur after intraaortic balloon pump insertion, prolonged femoral vessel cannulation, percutaneous cardiopulmonary bypass, dissecting aneurysms, or emboli. Normal blood reperfusion can cause a postischemic syndrome that increases morbidity and mortality. This clinical study is based on an experimental infrastructure patterned after controlled cardiac reperfusion. (1) It tests the hypothesis that controlled limb reperfusion (i.e., modifying the composition of the initial reperfusate and the conditions of reperfusion) reduces the local and systemic complications seen after normal blood reperfusion. (2) It reports initial clinical application of this strategy in three cardiac surgery centers. Controlled limb reperfusion was applied to 19 patients with signs of severe prolonged unilateral or bilateral ischemia (including paralysis, anesthesia, and muscle contracture); six patients (32%) were in cardiogenic shock. The mean ischemic duration was 26 +/- 6 hours. The reperfusion method includes a 30-minute infusion into the distal vessels of a normothermic reperfusate solution mixed with the patient's arterial blood (obtained proximal to the obstruction) in a 6:1 blood/repe...Continue Reading

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Citations

Apr 19, 2000·The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyōbu Geka Gakkai Zasshi·Y SakakibaraT Mitsui
Dec 23, 2003·The Journal of Thoracic and Cardiovascular Surgery·Bradley S AllenZhongtou Tan
Mar 21, 2009·Seminars in Vascular Surgery·Friedhelm Beyersdorf, Christian Schlensak
Jun 16, 2009·The Journal of Surgical Research·Ulf Abdel-RahmanFriedhelm Beyersdorf
Sep 16, 2004·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Friedhelm Beyersdorf
Aug 2, 2015·General Thoracic and Cardiovascular Surgery·Ikuo FukudaWakako Fukuda
Nov 30, 2014·Annals of Vascular Surgery·Christian A P SchmidtMarkus J Wilhelm
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Jun 30, 2019·Biomechanics and Modeling in Mechanobiology·Elad BullkichSaar Golan
Apr 27, 2010·The Journal of Thoracic and Cardiovascular Surgery·Gerald D Buckberg

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