1) The document discusses the safety and effectiveness of unilateral antegrade cerebral perfusion in aortic arch surgery.
2) It reports on 108 patients who underwent aortic arch surgery using unilateral right antegrade cerebral perfusion via cannulation of the right axillary or innominate artery.
3) The results showed low mortality and neurological deficit rates, suggesting unilateral cerebral perfusion is adequate for aortic arch surgery in most cases, though bilateral perfusion is needed if left cerebral saturation decreases significantly.
Austin Biomarkers & Diagnosis is a peer-reviewed, open access journal published by Austin Publishers. It provides easy access to high quality Manuscripts covering aspects of measure and evaluation to examine normal biological processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention. It also focus upon aspects of dynamic and powerful approaches in understanding the spectrum of disease with applications in observational and analytic epidemiology, randomized clinical trials, screening and diagnosis.
Austin Publishing Group is a successful host of more than hundred peer reviewed, open access journals in various fields of science and technology with intent to bridge the gap between academia and research access.
Austin Biomarkers & Diagnosis accepts original research articles, review articles, case reports, mini reviews, rapid communication, opinions and editorials on all the related aspects of biomarkers involved in normal biological processes, pathological process, and pharmacological responses as well as in diagnosing diseases.
Intracranial arteriovenous malformation in an infant—vein of Galen malformationApollo Hospitals
The vein of Galen malformation is a rare cerebrovascular disorder which is characterized by an abnormal direct communication between one or several cerebral arteries and the vein of Galen. In neonates, it usually causes congestive heart failure. Infants, older children, and adults usually present with mass effect, seizures, or intracranial hemorrhage. Here, we report a 6-month-old infant diagnosed with the vein of Galen malformation antenatally and presented to us with acute hydrocephalus. She underwent emergency embolization, developed in right femoral artery thrombosis as a complication requiring emergency thrombectomy and end-to-end repair. After embolization, she stabilized but hydrocephalus and raised intracranial tension persisted for which she required endoscopic third ventriculostomy.
The field of perfusion is becoming increasingly demanding both clinically and didactically. As the patient population continues to present with a variety of complex health issues, there is a greater need than ever for the Pefusionist to develop new techniques for patient care while on Cardiopulmonary Support. Ascending Aortic Arch dissections (AAAD), with its current mortality rates of 10%-15% with significant neurological complications associated, still remains a difficult case for Perfusionist’s to manage effectively. The most widely used technique during this type of repair surgery, is hypothermic circulatory arrest (HCA). Although this remains a premier technique, there continues to be a high reported incidence of neurological deficit post HCA. In order to address and limit this issue, the advent of selective cerebral perfusion is slowly gaining acceptance. This new technique has been shown to not only decrease the time of exposure of blood to a foreign surface, but limit the patient duration on full cardiopulmonary support. The most notable aspect of this technique; is it allows the surgeon to begin repairs immediately, since the process cools the brain only, while keeping the rest of body at moderate-mild hypothermic levels.
Austin Biomarkers & Diagnosis is a peer-reviewed, open access journal published by Austin Publishers. It provides easy access to high quality Manuscripts covering aspects of measure and evaluation to examine normal biological processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention. It also focus upon aspects of dynamic and powerful approaches in understanding the spectrum of disease with applications in observational and analytic epidemiology, randomized clinical trials, screening and diagnosis.
Austin Publishing Group is a successful host of more than hundred peer reviewed, open access journals in various fields of science and technology with intent to bridge the gap between academia and research access.
Austin Biomarkers & Diagnosis accepts original research articles, review articles, case reports, mini reviews, rapid communication, opinions and editorials on all the related aspects of biomarkers involved in normal biological processes, pathological process, and pharmacological responses as well as in diagnosing diseases.
Intracranial arteriovenous malformation in an infant—vein of Galen malformationApollo Hospitals
The vein of Galen malformation is a rare cerebrovascular disorder which is characterized by an abnormal direct communication between one or several cerebral arteries and the vein of Galen. In neonates, it usually causes congestive heart failure. Infants, older children, and adults usually present with mass effect, seizures, or intracranial hemorrhage. Here, we report a 6-month-old infant diagnosed with the vein of Galen malformation antenatally and presented to us with acute hydrocephalus. She underwent emergency embolization, developed in right femoral artery thrombosis as a complication requiring emergency thrombectomy and end-to-end repair. After embolization, she stabilized but hydrocephalus and raised intracranial tension persisted for which she required endoscopic third ventriculostomy.
The field of perfusion is becoming increasingly demanding both clinically and didactically. As the patient population continues to present with a variety of complex health issues, there is a greater need than ever for the Pefusionist to develop new techniques for patient care while on Cardiopulmonary Support. Ascending Aortic Arch dissections (AAAD), with its current mortality rates of 10%-15% with significant neurological complications associated, still remains a difficult case for Perfusionist’s to manage effectively. The most widely used technique during this type of repair surgery, is hypothermic circulatory arrest (HCA). Although this remains a premier technique, there continues to be a high reported incidence of neurological deficit post HCA. In order to address and limit this issue, the advent of selective cerebral perfusion is slowly gaining acceptance. This new technique has been shown to not only decrease the time of exposure of blood to a foreign surface, but limit the patient duration on full cardiopulmonary support. The most notable aspect of this technique; is it allows the surgeon to begin repairs immediately, since the process cools the brain only, while keeping the rest of body at moderate-mild hypothermic levels.
Posterior fossa is a shallow space accommodating brainstem and cerebellum. Bleed in the cerebellum can cost life as it leads to rapid deterioration by hydrocephalus and upward herniation.
Details of Cerebrospinal Fluid special reference to cell count and alteration of CSF Hydrodynamics explained in brief and Different Diagnostic parameters to Hydrocephalus
Posterior fossa is a shallow space accommodating brainstem and cerebellum. Bleed in the cerebellum can cost life as it leads to rapid deterioration by hydrocephalus and upward herniation.
Details of Cerebrospinal Fluid special reference to cell count and alteration of CSF Hydrodynamics explained in brief and Different Diagnostic parameters to Hydrocephalus
A study to assess the effectiveness of structured teaching program on knowledge regarding care of patients after cardiac surgery among staff nurses at Shree Narayana, Hospital, Raipur, chhattisgarh.
Stroke a rare complication in Post PCI patientPRAVEEN GUPTA
In this ppt i am going to describe about one patient who develop acute stroke after PCI in our hospital. Also i am going to discuss how to diagnose, manage and treat such patient, risk factor associated with stroke after PCI.
Management of Increased intracranial pressure in cerebellar strokeNeurology Residency
Brief presentation of medical and surgical treatment options for massive cerebellar stroke. Discussion between placement of an extraventricular drain or suboccipital decompressive craniectomy.
A Case Report of Hypothermia Rescued by Veno-Arterial Extracorporeal Membrane...semualkaira
Severe hypothermia is a life-threatening condition that often causes hemodynamic instability or cardiac arrest
and carries a high risk of mortality. The use of VA-ECMO in this
indication has greatly improved the prognosis of patients.
A Case Report of Hypothermia Rescued by Veno-Arterial Extracorporeal Membrane...semualkaira
Severe hypothermia is a life-threatening condition that often causes hemodynamic instability or cardiac arrest
and carries a high risk of mortality. The use of VA-ECMO in this
indication has greatly improved the prognosis of patients.
A Case Report of Hypothermia Rescued by Veno-Arterial Extracorporeal Membrane...semualkaira
Severe hypothermia is a life-threatening condition that often causes hemodynamic instability or cardiac arrest and carries a high risk of mortality. The use of VA-ECMO in this indication has greatly improved the prognosis of patients
A Case Report of Hypothermia Rescued by Veno-Arterial Extracorporeal Membrane...semualkaira
Severe hypothermia is a life-threatening condition that often causes hemodynamic instability or cardiac arrest and carries a high risk of mortality. The use of VA-ECMO in this indication has greatly improved the prognosis of patients
A Case Report of Hypothermia Rescued by Veno-Arterial Extracorporeal Membrane...semualkaira
Severe hypothermia is a life-threatening condition that often causes hemodynamic instability or cardiac arrest
and carries a high risk of mortality. The use of VA-ECMO in this
indication has greatly improved the prognosis of patients
Global Hospitals’ Advanced Heart, Lung & Vascular Institute provides all kinds of endovascular procedures including coronary intervention and peripheral intervention, heart surgery, heart bypass surgery as well as heart transplantation surgery in Hyderabad, Chennai, and Bangalore
SUMMARY:
- Neurophysiologic monitoring not universally adopted but in many centers has become routine monitor for some surgical procedures
- Ideal neurophysiologic monitoring in the neurosurgical procedure should be: non-invasive (v.s invasive), high sensitivity & specificity, cost effective, easy to use, simple instrumentation, and real time or continous monitoring.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
![SAFETY OF ANTEGRADE CEREBRAL UNILATERAL PERFUSION IN AORTIC ARCH SURGERY C.Cavozza, P.Scoti, A.Audo, D. Mercogliano, M. Serra, P. Spitaleri, G. Camporini, C. Manca, D. Ricci, G. Parodi, L. De Silva, A. Pergolo and D. Medici Cardiac Surgery and Cardiac Anesthesia, Azienda Ospedaliera Alessandria, Italty ,[object Object],[object Object],Male 72 ,[object Object],36 Elective 36 Emergency 72 Emergency Elective ? And the brain? Surgical Procedures Direct or side-graft Innominate artery cannulation Chronic type A Aortic Dissection Annuloectasia involving ascending hemiarch Ascending aortic aneurysm involving ascending hemiarch ,[object Object],Bentall with ascending hemiarch replacement 5 Asacending aorta and hemiarch replacement 4 5* Bentall with total arch replacement and TSA reimplantation 3 8 11 David with partial arch replacement 5 Cabrol with total arch replacement and TSA reimplantation 3 Ascending aorta with total arch replacement and TSA reimplantation with Elephant trunk 2 Elective Surgical Procedures Emergency Surgical Procedures Type A Standford aortic dissection or De Bakey I/II Redo Bentall with Ascending hemiarch replacement 16 Ascending aorta and ascending hemiarch replacement 51 6 Wheat and hemiarch replacement 3 Ascending aorta and total arch replacement and TSA reimplantation with elephant trunk 2 SITES OF ARTERIAL CANNULATION DURING CPB Brain Perfusion during circulatory arrest 24 patients 14 patients Patients were cooled to 26° C of rectal temperature . Rigth antegrade perfusion started at flow rate of 10-15 cc/Kg/min with an brain inflow temperature of 25° C When arch and Femoral artery are cannulated a Coronary sinus catheter is inserted into innominate artery for brain perfusion To asses brain perfusion we used infrared spectroscopy scalp capillary saturation by a dual sensor for NIRS Attached to the patient's forehead to monitor the tissur oxygenation index (TOI) in the bilateral frontal lobe. Anesthesia was maintaned by continous intravenous propofol, remifentanyl and cis-atracurium infusion. The Bispectral index (BIS) was monitored with BIS monitor to mantain the depth of anesthesia. The BIS index was maintained from 35 to 45 at the beginning and from 0 to 20 during circulatory arrest ( Bust Soppression), to reduce cerebral oxigen demand (CMRO2) NIRS ,[object Object],Bilateral brain perfusion CPB time/min ,[object Object],[object Object],Transient Neurologic deficit ,[object Object],106 2 191 +/- 53 ,[object Object],8%* ,[object Object],[object Object],When left saturation decreased to abnormal values, Bilateral Cerebral Perfusion is mandatory The best surgical approach for cerebral protection, during open distal anastomosys, is still a matter of controversy. In our experience unilateral brain perfusion on hypothermia in most of cases is adeguate for allowing safe and better surgical view in surgery of aortic arch. When left cerebral saturation decreases respect baseline values , bilateral cerebral perfusion is mandatory to obtain good outcome. 32 patients Side-Graft Axillary artery cannulation 38 patients In all cases the innominate and the left carotid arteries were snared ,while the left subclavian artery was occluded by Swan Ganz catheter Side-graft femoral artery cannulation Arch cannulation This approach, based on our experience, help correct decrease in cerebral saruration values. Ideally baseline values should be obtained when the patients is awake, resting comfortable with O2 supplementation. We define abnormal rSO2 (regional SO2 saturation) as a 20% left reduction from baseline values or an absolute decrease of 50% 1: induction of anesthesia; 2: onset of CPB; 3:cooling on CPB; 4: unilateral right cerebral perfusion; 5: profound left saturation; 6: perfusion via left carotid cannula * In this patient we performed also bilateral pulmonary thromboendoarterectomy * operative mortality was defined as death during first 30 days after the operation .The overall mortalityi ncludes : three intraoperative exsanguination, two low cardiac output and four for multiorgan failure ** Temporary neurologic dysfunction was defined as presence of reversible postoperative motor deficit,confusion, agitation, or transient delirium. The computed tomography scan had to be normal and all symptoms resolved before discharge . ***Four patients sustained perioperative permanent neurologic damage(hemiplegia, paraparesis, multiple cerebral infarction) Bilateral antegrade selective cerebral perfusion By Kazui Baylor college of Medicine Houston, Texas 1-2 may, 2009 7 th Current trends in Aortic and Cardiothoracic Surgery Conclusions RESULTS Neuromonitoring Clinical Data OBJECTIVE BACKGROUND Materials & Methods Since De Bakey's first successful repair of aortic arch aneurysm in 1957, understanding of the aortic arch pathology, neuroprotective strategies, neuromonitoring and surgical technique have markedly improved. Adeguate brain protection is essential and commonly performed in our Institution by either antegrade selective perfusion of the brachiocefalic arteries, retrograde cerebral perfusion or an interval of profound hyphotermic circulatory arrest. . We present our experience for open distal aortic surgery with antegrade unilateral brain perfusion by means of cannulation of the right axillary or innominate artery .](https://image.slidesharecdn.com/posterhouston-090507104819-phpapp01/85/Poster-Houston-1-320.jpg)
