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

[prasannasimha]

No the serpentine cooler - can you photograph it - is it reusable or 
disposable ?
Prasanna

Dr. Roberto Battellini wrote:
> A spiral, a streamer. Comes from snake or serpent.
>
> Roberto
>
> -----Ursprüngliche Nachricht-----
> Von: openheart-l-bounces at lists.hsforum.com
> [mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von psimha
> Gesendet: Donnerstag, 21. Dezember 2006 14:53
> An: OpenHeart-L at lists.hsforum.com
> Betreff: Re: AW: [HSF] the little heat exchanger for arch op´s
>
> 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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