Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Making heart surgery more brain-friendly

05.12.2002


Surgeons at University Hospitals of Cleveland have demonstrated that the risk of brain damage associated with the use of the heart lung machine can be significantly reduced by modifying the traditional placement of cannulas (tubing) for returning blood flow to the patient. The findings were presented last month at the American Heart Association’s annual Scientific Sessions conference in Chicago, Ill.



The neurological problems associated with bypass surgery have been widely reported. As much as 6 percent to 10 percent of bypass patients will experience memory loss, visual changes, or even stroke. Surgeons believe these outcomes are partly due to "debris" lining the aorta that may break off during surgery--under pressure exerted by the heart-lung bypass machine (which keeps blood flowing to the brain).

Alan Markowitz, MD, and a team of researchers at The Research Institute of University Hospitals of Cleveland and Case Western Reserve University studied the patterns of blood flow to the brain on the heart-lung machine and the risk of stroke from debris released into the aorta, the conventional site of blood return flow to the patient.


Under the standard approach, surgeons place a cannula into the ascending aorta, forcing blood to flow through the aorta and upwards to the brain. Dr. Markowitz’s team selected a different blood vessel. They placed the cannula into the axillary artery, a branch of the aortic arch providing direct blood flow to the right side of the brain. This innovative approach significantly reduced the flow of emboli (debris) to the brain.

"Axillary perfusion appears to deflect debris away from the brain and markedly limits postoperative neurological complications," Dr. Markowitz says. He has used this approach (to cannulate the axillary artery instead of the aorta) in several hundred adult heart surgery patients who were at higher risk for stroke. The results showed a very low incidence of stroke in this high-risk patient population.

"Our clinical experience with such a low stroke rate in these high-risk patients stimulated us to go back to the lab to work out the reason, and we were able to prove our hypothesis," Dr. Markowitz says.

In the laboratory, the research team conducted studies on dogs after modifying the aortic arch to mimic the human anatomy. Their results were gratifying. "We tracked microscopic emboli using fluorescent markers," says Dr. Markowitz. "The placement of the cannula in the axillary artery resulted in a 75 percent decrease in the number of emboli flowing to the right side of the brain, and a 45 percent decrease in the number of emboli flowing to the left side of the brain."

Dr. Markowitz presented his findings in the American Heart Association’s "Stroke Risk and Reduction" section. His presentation was entitled, "Axillary Artery Cannulation for Cardiopulmonary Bypass Reduces Cerebral Microemboli."

Eric Sandstrom | EurekAlert!
Further information:
http://www.uhhs.com/

More articles from Health and Medicine:

nachricht Researchers identify new way to unmask melanoma cells to the immune system
17.01.2018 | Duke University Medical Center

nachricht Study advances gene therapy for glaucoma
17.01.2018 | University of Wisconsin-Madison

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Scientists decipher key principle behind reaction of metalloenzymes

So-called pre-distorted states accelerate photochemical reactions too

What enables electrons to be transferred swiftly, for example during photosynthesis? An interdisciplinary team of researchers has worked out the details of how...

Im Focus: The first precise measurement of a single molecule's effective charge

For the first time, scientists have precisely measured the effective electrical charge of a single molecule in solution. This fundamental insight of an SNSF Professor could also pave the way for future medical diagnostics.

Electrical charge is one of the key properties that allows molecules to interact. Life itself depends on this phenomenon: many biological processes involve...

Im Focus: Paradigm shift in Paris: Encouraging an holistic view of laser machining

At the JEC World Composite Show in Paris in March 2018, the Fraunhofer Institute for Laser Technology ILT will be focusing on the latest trends and innovations in laser machining of composites. Among other things, researchers at the booth shared with the Aachen Center for Integrative Lightweight Production (AZL) will demonstrate how lasers can be used for joining, structuring, cutting and drilling composite materials.

No other industry has attracted as much public attention to composite materials as the automotive industry, which along with the aerospace industry is a driver...

Im Focus: Room-temperature multiferroic thin films and their properties

Scientists at Tokyo Institute of Technology (Tokyo Tech) and Tohoku University have developed high-quality GFO epitaxial films and systematically investigated their ferroelectric and ferromagnetic properties. They also demonstrated the room-temperature magnetocapacitance effects of these GFO thin films.

Multiferroic materials show magnetically driven ferroelectricity. They are attracting increasing attention because of their fascinating properties such as...

Im Focus: A thermometer for the oceans

Measurement of noble gases in Antarctic ice cores

The oceans are the largest global heat reservoir. As a result of man-made global warming, the temperature in the global climate system increases; around 90% of...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

10th International Symposium: “Advanced Battery Power – Kraftwerk Batterie” Münster, 10-11 April 2018

08.01.2018 | Event News

See, understand and experience the work of the future

11.12.2017 | Event News

Innovative strategies to tackle parasitic worms

08.12.2017 | Event News

 
Latest News

Morbid Obesity: Gastric Bypass and Sleeve Gastrectomy Are Comparable

17.01.2018 | Health and Medicine

Researchers identify new way to unmask melanoma cells to the immune system

17.01.2018 | Health and Medicine

Genetic discovery may help better identify children at risk for type 1 diabetes

17.01.2018 | Health and Medicine

VideoLinks
B2B-VideoLinks
More VideoLinks >>>