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Cerebral Embolization (cerebral + embolization)
Selected AbstractsClinical and Echocardiographic Risk Factors for Embolization in the Presence of Left Atrial ThrombusECHOCARDIOGRAPHY, Issue 5 2007Ela Sahinbas Kavlak Aims: The aim of our study was to evaluate the factors leading to embolization in patients with left atrial thrombi (LAT). With this purpose, we retrospectively analyzed clinical, transthoracic, transesophageal echocardiographic data of patients with LAT in the transesophageal echocardiographic evaluation. Methods and Results: One hundred ninety-two patients with LAT not on anticoagulant therapy were divided into two groups according to the presence of prior ischemic stroke. The group with ischemic stroke included more patients with sinus rhythm and less patients with mitral stenosis. They had smaller left atrial diameter, more left atrial appendage spontaneous echo-contrast, higher appendage ejection fraction, and emptying velocity. Conclusion: Once the thrombus has been formed, cerebral embolization seems to be higher in patients with relatively preserved appendage ejection fraction and emptying velocity. Presence of atrial appendage spontaneous echo-contrast also favor embolization. Factors leading to embolization seem to differ in some respects from the causes of thrombus formation. [source] Is It Safe to Initiate Selective Cerebral Perfusion with Normothermia?JOURNAL OF CARDIAC SURGERY, Issue 5 2005Mizuho Imamaki M.D. Cerebral circulation is isolated from systemic circulation to avoid cerebral embolization due to detachment of atherosclerotic material from the aorta, caused by the "sandblasting" effect of high-velocity jets of blood exiting the aortic cannula. However, neither the safety of SCP at normothermia nor the influence of extended SCP time has been sufficiently clarified. To clarify the safety of P-SCP, the comparison study of P-SCP and conventional SCP (C-SCP) was performed retrospectively. Methods: Fifty-seven patients (C-SCP group: 29 patients; P-SCP: 28 patients) underwent surgery between 1992 and 2002. Results: Nine (15.8%) in-hospital death occurred; 4 in the C-SCP group (13.8%) and 5 in the P-SCP group (17.9%) (NS). The SCP time was 136.6 ± 68.5 minutes in the C-SCP group and 195.8 ± 30.7 minutes in the P-SCP group (p < 0.05). One patient in each group exhibited postoperative neurological dysfunction. Conclusion: It may be little dangerous to initiate the SCP with normothermia. P-SCP may be useful in cases in which there is pedunculated atherosclerotic material, or mural thrombus in the ascending and arch aorta. [source] Evaluation of Membrane Oxygenators and Reservoirs in Terms of Capturing Gaseous Microemboli and Pressure DropsARTIFICIAL ORGANS, Issue 11 2009Yulong Guan Abstract An increasing amount of evidence points to cerebral embolization during cardiopulmonary bypass (CPB) as the principal etiologic factor of neurologic complications. In this study, the capability of capturing and classification of gaseous emboli and pressure drop of three different membrane oxygenators (Sorin Apex, Terumo Capiox SX25, Maquet QUADROX) were measured in a simulated adult model of CPB using a novel ultrasound detection and classification quantifier system. The circuit was primed with 1000 mL heparinized human packed red blood cells and 1000 mL lactated Ringer's solution (total volume 2000 mL, corrected hematocrit 26,28%). After the injection of 5 mL air into the venous line, an Emboli Detection and Classification Quantifier was used to simultaneously record microemboli counts at post-pump, post-oxygenator, and post-arterial filter sites. Trials were conducted at normothermic (35°C) and hypothermic (25°C) conditions. Pre-oxygenator and post-oxygenator pressure were recorded in real time and pressure drop was calculated. Maquet QUADROX membrane oxygenator has the lowest pressure drops compared to the other two oxygenators (P < 0.001). The comparison among the three oxygenators indicated better capability of capturing gaseous emboli with the Maquet QUADROX and Terumo Capiox SX25 membrane oxygenator and more emboli may pass through the Sorin Apex membrane oxygenator. Microemboli counts uniformly increased with hypothermic perfusion (25°C). Different types of oxygenators and reservoirs have different capability of capturing gaseous emboli and transmembrane pressure drop. Based on this investigation, Maquet QUADROX membrane oxygenator has the lowest pressure drop and better capability for capturing gaseous microemboli. [source] Giant thrombus trapped in foramen ovale with paradoxical cerebral embolization and strokeCLINICAL CARDIOLOGY, Issue 10 2006Horst Wedekind M.D. No abstract is available for this article. [source] | ||||||||||