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

[psimha]

What's a Serpentine ?
Prasanna
Dr. Roberto Battellini wrote:
> 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
>
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