Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2023 Aug 1;9(3):101276.
doi: 10.1016/j.jvscit.2023.101276. eCollection 2023 Sep.

Intraoperative immunomodulation during left heart bypass in open thoracoabdominal aortic aneurysm repair

Federico Pascucci  1 , Tommaso Donati  1 , Giovanni Tinelli  1 , Gabriella Arlotta  2 , Antonio Luparelli  1 , Yamume Tshomba  1
Affiliations
Case Reports

Intraoperative immunomodulation during left heart bypass in open thoracoabdominal aortic aneurysm repair

Federico Pascucci et al. J Vasc Surg Cases Innov Tech. .

Abstract

Despite the technical innovations introduced in the previous decades, open thoracoabdominal aortic aneurysm repair still represents an enormous challenge for patients and surgeons. Logically, the systemic inflammatory response resulting from these massive operations appears considerable; however, the response has never been thoroughly investigated. In addition, intraoperative adjuncts to modulate the postoperative activation of the immune system have not yet been introduced into clinical practice. We report a case of intraoperative hemadsorption during open repair of a thoracoabdominal aortic aneurysm through the introduction of a CytoSorb device (CytoSorbents Corp) in the left heart bypass circuit. The technique appeared feasible and safe and probably contributed to the good clinical outcomes.

Keywords: CytoSorb; Left heart bypass; Thoracoabdominal aortic aneurysm.

PubMed Disclaimer

Figures

Fig 1
Fig 1
Intraoperative photograph showing the CytoSorb cartridge integrated into the left heart bypass (LHB) circuit.
Fig 2
Fig 2
Intraoperative photograph showing the left heart bypass (LHB) circuit.
Fig 3
Fig 3
Intraoperative photograph showing selective visceral perfusion with isothermic blood for the celiac trunk and superior mesenteric artery and Custodiol solution for the renal arteries and distal beveled anastomosis.
Fig 4
Fig 4
Intraoperative photograph showing final aortic reconstruction with intercostal artery reimplantation through an island patch.
See this image and copyright information in PMC

References

    1. Coselli J.S., LeMaire S.A., Preventza O., et al. Outcomes of 3309 thoracoabdominal aortic aneurysm repairs. J Thorac Cardiovasc Surg. 2016;151:1323–1337. - PubMed
    1. Tshomba Y., Bertoglio L., Marone E.M., Melissano G., Chiesa R. Visceral aortic patch aneurysm after thoracoabdominal aortic repair: conventional vs hybrid treatment. J Vasc Surg. 2008;48:1083–1091. - PubMed
    1. Yuan H.X., Chen Y.T., Li Y.Q., et al. Endothelial extracellular vesicles induce acute lung injury via follistatin-like protein 1. Sci China Life Sci. 2023:1–15. - PMC - PubMed
    1. Buesing K.L., Densmore J.C., Kaul S., et al. Endothelial microparticles induce inflammation in acute lung injury. J Surg Res. 2011;166:32–39. - PMC - PubMed
    1. Bubenek-Turconi S.I., Corneci D., Scarlat C., Baila S., Marinescu P., Valeanu L. Veno-venous extracorporeal membrane oxygenation, cytokine removal and continuous renal replacement therapy in a severe burn adult patient. Int J Artif Organs. 2023;46:120–125. - PubMed

Publication types

LinkOut - more resources