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E-grāmata: Minimized Cardiopulmonary Bypass Techniques and Technologies

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Edited by (University of Strathclyde, UK), Edited by (Professor of Cardiovascular Surgery, University of Health Sciences, Ankara City Hospital Campus, Turkey)
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Cardiovascular surgeons and related medical specialists describe minimized versions of bypassing the heart and lungs during cardiac surgery, which is not yet widely practiced, but shows promise for reducing blood loss, blood transfusions, haemodilution, and stroke. They emphasize issues that must be overcome before the approach can become common. Among their topics are the historical development of minimized cardiopulmonary bypass, the blood-surface interface in miniaturized extracorporeal circulation systems, myocardial preservation techniques for mini-bypass, valve surgery using minimized perfusion circuits, and comparing minimized circulation with off-pump coronary artery bypass grafting and conventional surgery. Annotation ©2012 Book News, Inc., Portland, OR (booknews.com)

Traditional cardiopulmonary bypass (CPB) techniques have suffered from a number of disadvantages including haemodilution, inflammation and post-operative bleeding. Minimized cardiopulmonary bypass techniques use developments in perfusion technology to significantly reduce foreign surface-blood interactions to make bypass simpler and safer.

This important book reviews key developments and issues relating to this promising technology. Part one covers the broad range of CPB pathophysiology, including anticoagulant protocols, the impact of CPB circuit surfaces, optimal haemodilution levels, and the important issue of CPB-induced systemic inflammatory response syndrome. Parts two and three focus on the issues of the new equipment developed for mini-CPB, optimal myocardial protection protocols and CPB perfusate options and discuss clinical issues, including patient selection, coronary and valve surgery protocols and, among others, pediatric patients.

Recenzijas

"The book is comprehensive in its scope and authoritative in the experience of its chapter authors. I commend the book to all members of cardiac surgery teams - surgeons, cardiologists, anaesthetists and perfusionists." --Professor Ken Taylor, Emeritus Professor of Cardiac Surgery, Imperial College and The Hammersmith Hospital, London (from the Foreword)

Contributor contact details xi
Foreword xv
Professor Ken Taylor
Part I Introduction to minimized cardiopulmonary bypass
1(112)
1 Historical development of minimised cardiopulmonary bypass
3(14)
T. Gourlay
1.1 Introduction and historical perspective
3(1)
1.2 Cardiopulmonary bypass: from pioneering to refinement
4(3)
1.3 Cardiopulmonary bypass: does size matter?
7(5)
1.4 Conclusions
12(1)
1.5 References
13(4)
2 Anticoagulation protocols for minimized cardiopulmonary bypass
17(18)
M. Ranucci
2.1 Introduction: blood activation during cardiac surgery with cardiopulmonary bypass (CPB)
17(3)
2.2 Anticoagulation during CPB: basic principles and historical notes
20(3)
2.3 Heparin-bonded surfaces and other biocompatible treatments
23(1)
2.4 Reduced systemic heparinization (RSH)
23(5)
2.5 Contraindications
28(1)
2.6 Future trends
29(1)
2.7 References
30(5)
3 Minimized extracorporeal circulation: physiology and pathophysiology
35(10)
I. Dimarakis
V. Joshi
W. Hesford
3.1 Introduction: basic principles
35(2)
3.2 The inflammatory cascade and biomarkers
37(5)
3.3 Conclusions
42(1)
3.4 References
42(3)
4 Blood--surface interface in miniaturised extracorporeal circulation systems
45(17)
T. Gourlay
L. Shedden
4.1 Introduction
45(1)
4.2 Blood--surface contact in cardiopulmonary bypass (CPB)
46(4)
4.3 Clinical benefits of miniaturised extracorporeal circulation systems
50(6)
4.4 References
56(6)
5 Hemodilution: physiology and pathophysiology
62(24)
J. Wegner
5.1 Introduction
62(1)
5.2 Basic physiology and pathophysiology of hemodilution
63(3)
5.3 Microvascular alterations with hemodilution
66(1)
5.4 Hemodilution and cardiopulmonary bypass (CPB)
67(3)
5.5 Determinants of tissue oxygenation -- functional capillary density (FCD)
70(5)
5.6 Conclusions
75(1)
5.7 References
76(10)
6 Inflammatory response and minimized cardiopulmonary bypass
86(27)
A. H. Olivencia-Yurvati
R. T. Mallet
6.1 Introduction
86(1)
6.2 Cardiopulmonary bypass (CPB)-induced inflammatory cascade
87(6)
6.3 Pharmacological antioxidants for CPB: impact on biochemical and clinical outcomes
93(6)
6.4 Minimized CPB circuits
99(3)
6.5 Acknowledgements
102(1)
6.6 References
102(10)
6.7 Appendix: abbreviations
112(1)
Part II Minimized cardiopulmonary bypass equipment
113(42)
7 Design and principles of the minimized extracorporeal circuit
115(18)
H. I. Ucar
A. C. Yorgancioglu
S. Gunaydin
7.1 Introduction
115(1)
7.2 Basic principles of minimized extracorporeal circulation
116(1)
7.3 Evolution of minimized circuits
116(1)
7.4 Minimized extracorporeal systems currently available
117(9)
7.5 Surgical applications of minimized extracorporeal circulation
126(1)
7.6 Controversies and challenges facing minimized cardiopulmonary bypass
127(1)
7.7 Future trends in minimized cardiopulmonary bypass
128(1)
7.8 References
129(4)
8 Cardiopulmonary bypass perfusate
133(8)
D. Phiroz
8.1 Introduction
133(1)
8.2 Crystalloid primes
133(1)
8.3 Types of crystalloids and colloid agents used in prime
134(1)
8.4 Pharmacological agents used in prime
135(1)
8.5 Using prime in CPB procedures
136(1)
8.6 Examples of prime combinations
137(1)
8.7 Minimizing the use of prime
138(1)
8.8 Conclusions
139(1)
8.9 References
139(2)
9 Myocardial preservation techniques for mini-bypass
141(14)
M. Zakkar
P. P. Punjabi
9.1 Introduction
141(1)
9.2 Methods of myocardial protection
142(5)
9.3 Myocardial protection in mini-bypass
147(2)
9.4 Conclusion
149(1)
9.5 References
150(5)
Part III Clinical applications of minimized cardiopulmonary bypass
155(90)
10 Minimised cardiopulmonary bypass: objectives and indications
157(19)
A. El-Essawi
W. Harringer
10.1 Introduction: objectives of minimised cardiopulmonary bypass
157(12)
10.2 Indications and patient selection
169(3)
10.3 Future trends
172(1)
10.4 References
172(4)
11 Coronary artery bypass grafting (CABG)
176(13)
J. Skorpil
T. Hajek
11.1 Introduction
176(1)
11.2 History of coronary artery bypass grafting (CABG)
177(3)
11.3 Patient selection (indications) for mini-invasive cardiopulmonary bypass
180(3)
11.4 Conduits
183(1)
11.5 Anastomoses techniques
184(1)
11.6 Surgical management on mini-invasive cardiopulmonary bypass
185(1)
11.7 Conclusions
186(1)
11.8 References
187(2)
12 Valve surgery using minimized perfusion circuits
189(7)
I. Kutschka
H. Baraki
12.1 Introduction
189(1)
12.2 Surgical and technical aspects
189(2)
12.3 Blood management and patient treatment in valve surgery
191(2)
12.4 Experience with closed-loop perfusion circuits in valve surgery
193(1)
12.5 References
193(3)
13 Minimising cardiopulmonary bypass in children
196(23)
M. H. D. Danton
I. Torrance
13.1 Introduction
196(1)
13.2 Challenges of cardiopulmonary bypass (CPB) in the congenital patient
197(2)
13.3 Potential goals of mini-CPB
199(3)
13.4 Mini-CPB and neurological outcome
202(1)
13.5 Mini-CPB circuit design options in congenital heart surgery
203(9)
13.6 Clinical trials
212(1)
13.7 Alternative procedures to CPB
212(1)
13.8 Conclusions
213(1)
13.9 References
213(5)
13.10 Appendix: abbreviations
218(1)
14 Comparison of minimized circulation with off-pump coronary artery bypass (OPCAB) grafting and conventional surgery
219(10)
U. Demirkilic
E. Sener
S. Gunaydin
14.1 Introduction
219(2)
14.2 Controversies and challenges facing off-pump coronary artery bypass (OPCAB) grafting
221(2)
14.3 Studies comparing OPCAB with mini-cardiopulmonary bypass (mini-CPB) and mini-CPB assisted OPCAB
223(2)
14.4 Future trends and competition between OPCAB and minimized cardiopulmonary bypass
225(1)
14.5 References
226(3)
15 Minimally invasive cardiac surgery, port-access and robotic surgery
229(16)
T. Modine
J. M. Elarid
15.1 Introduction
229(1)
15.2 Minimally invasive coronary artery bypass grafting
229(5)
15.3 Minimally invasive valve surgery
234(2)
15.4 Minimally invasive congenital surgery
236(1)
15.5 Minimally invasive treatment of atrial fibrillation
237(1)
15.6 Miscellaneous possibilities of minimally invasive surgery
238(1)
15.7 Robotic surgery
238(2)
15.8 Conclusions
240(1)
15.9 References
240(5)
Index 245
Terence Gourlay is Professor of Medical Diagnostics in the Department of Biomedical Engineering at University of Strathclyde, UK. Dr Gunaydin currently serves as a faculty and clinical professor in the Department of Cardiovascular Surgery in Ankara City Hospital Campus, University of Health Sciences, Turkey. He studied histology and embryology and received PhD in Biomaterial Sciences in Tokyo Heart Institute, Japan. He is the Vice President for International Society of Minimally Invasive Extracorporeal Circulation (MiECTIS) and General Secretary of Turkish Enhanced recovery After Surgery (ERAS) Society. He also works as the scientific board member in Giganode Foundation and Heart Team Education Association. He directs international scientific projects on clinical evaluation and biomaterial confirmation of novel cardiopulmonary bypass-related technologies based on the prevention of inflammatory response, patient blood management and ERAS.
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