AW: [HSF] the little heat exchanger for arch op´s

[Dr. Roberto Battellini]

No, for cardioplegia we use a cheap serpentine through ice, which could
eventually be used for brain perfusion through the cardioplegia cannula. But
this different heat exchanger allows a high flow and has controlled
temperature (which the serpentine does not).

Yesterday I did (big man, 75 years, Ao Stenosis + AAAneurysma calcified
aorta) ,a partial arch + Bentall-Kouchoukos with endarterectomy of the arch
stopping at 26 degrees, and cooled the brain at 20 degrees for 20 minutes-
all ok-, but the rewarming needed 2 hours of pump, we rewarm at no more than
8 degrees difference and no more than 37 degrees in the arterial line. Do
anyone rewarm with greater difference? And higher temperatures?. We try to
avoid brain ödema.
Roberto

-----Ursprüngliche Nachricht-----
Von: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von prasannasimha
Gesendet: Mittwoch, 20. Dezember 2006 13:45
An: OpenHeart-L at lists.hsforum.com
Betreff: [HSF] the little heat exchanger for arch op´s

Roberto sent me this picture to send to the Forum.
Roberto is it the same heat exchanger we use for the cardioplegia ?
I did not understand the statement Serpentine trough ice can you explain ?
Prasanna

Roberto wrote :
This is an old lady which got 12 hours before a total arch and stent in 
the descending.I wanted to take a photo from her, and answered she had 
not the teeth on!
 
We have for total arches a Y line which cools the brain perfusion deeper 
than the rest, then the body remains at 26-28 and the brain can be 
cooled to 18, thanks to a little heat exchanger.I´ll try to make a 
drawing later for the forum, It is a "Bachet"-like line, but only one 
oxygenator.
 

Here is the heat exchanger. Needed only for complete arch. For partial 
we use a serpentine trough ice, it is easier for the technicians and 
cheaper.
 
The DLP cannulas allow to control the pressure from there in the carotid 
perfusions.
We cannulate axillary artery and not truncus, as the latter has 
sometimes calcifications. You can prepare the axillary artery like for 
axillo-femoral bypass.
 
Roberto