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Maslova O.,Hemafund Ltd. | Fedevych O.,Ukrainian Childrens Cardiac Center | Shuvalova N.,Ukrainian Academy of Sciences | Deryabina O.,Ukrainian Academy of Sciences | And 3 more authors.
Cell and Tissue Banking | Year: 2015

The need for selection of the optimal material for the manufacturing of cardio-patches can be resolved by the use of cryostored autologous pericardial tissue. This short communication is a concise fragment of a large-scale research and demonstrates only the efficiency of cell culturing before and after pericardial preservation in the low temperature conditions. © 2015 Springer Science+Business Media Dordrecht Source


Chasovskyi K.,Ukrainian Childrens Cardiac Center | Yemets I.,Ukrainian Childrens Cardiac Center
Perfusion (United Kingdom) | Year: 2016

Objective: Previously, we reported that the oxyhemoglobin dissociation curve is shifted leftward in patients who receive autologous umbilical cord blood (UCB) during neonatal open heart surgery. In this study, we assessed whether allowing the pCO2 to rise during hypothermic cardiopulmonary perfusion would shift the curve back to the right and improve tissue oxygenation. Methods: The study population included prenatally diagnosed patients with transposition of the great arteries. The study cohort was divided into two groups and consisted of early patients originally managed with lower pCO2 levels (Group I, n=42, 2009-12) and later patients subsequently managed with higher pCO2 levels (Group II, n=38, 2012-14). Results: Patients received similar volumes of collected autologous UCB (Group I, 80 ml; Group II, 75ml, p=0.207) with a similar mean level of HbF during CPB (Group I, 90±8%; Group II, 87±9%, p=0.310). Higher levels of pCO2 during CPB (Group I, 31 mmHg; Group II, 37 mmHg, p=0.011) resulted in a rightward shift of the oxyhemoglobin dissociation curve (increased p50O2) (Group I, 19.5±3.4 mmHg; Group II, 22.5±2.2 mmHg, p=0.011). The use of a higher pCO2 strategy was associated with decreased serum lactate during CPB (Group I, 4.7±2 mmol/l; Group II, 2.8±1.4 mmol/l, p=0.001), decreased duration of mechanical ventilation (Group I, 46h; Group II, 22h, p<0.001) and decreased of length of intensive care unit (ICU) stay (Group I, 7.6±2.6, Group II, 5.6±2.2, p=0.003) Conclusions: A higher pCO2 during CPB in neonates who underwent open heart surgery using UCB resulted in a rightward shift of the oxyhemoglobin dissociation curve and was associated with improved serum lactate levels. © 2016 SAGE Publications. Source


Chasovskyi K.,Ukrainian Childrens Cardiac Center | Fedevych O.,Ukrainian Childrens Cardiac Center | McMullan D.M.,Surgery | Mykychak Y.,Ukrainian Childrens Cardiac Center | And 3 more authors.
Perfusion (United Kingdom) | Year: 2015

Background: This study evaluates the hemoglobin-oxygen relationship and tissue perfusion during cardiopulmonary bypass (CPB) in neonates undergoing open-heart surgery using autologous umbilical cord blood or donor blood components. Methods: We compared perioperative hematocrit (Hct), fetal hemoglobin (HbF), p50O2, pH, pCO2, serum lactate, duration of mechanical ventilation and intensive care unit (ICU) length of stay in neonates undergoing open-heart surgery using autologous umbilical cord blood (Group I, N=45) or donor blood components (Group II, N=65). The groups were similar with respect to diagnosis, weight, type of procedure, duration of CPB and duration of myocardial ischemia. Results: Mean p50O2 was significantly lower in Group I during CPB (19.7 vs. 22.3 mmHg, p=0.004) and at the end of CPB (20.1 vs. 22.8 mmHg, p=0.003). Median peak lactate during CPB was higher in Group I (4.8 vs. 2.2 mmol/l, p<0.001). Carbon dioxide tension was identified as an independent predictor of higher p50O2 during CPB in Group I (β=0.88, p=0.002), but not Group II. Bodyweight, Hct, duration of CPB, pre-CPB lactate level and pCO2 affected peak lactate level during CPB. Although mean duration of ventilation was longer in Group II (mean 51 vs. 43, p=0.004), the groups experienced similar duration of ICU stay (5.8 vs. 5.9 days, p=0.280). Conclusions: Despite the fact that the oxyhemoglobin dissociation curve is shifted leftward in patients who receive autologous umbilical cord blood, tissue oxygen delivery appears to be preserved in neonates who undergo open-heart surgery using autologous umbilical cord blood. © The Author(s) 2014. Source


Sekelyk R.,Ukrainian Childrens Cardiac Center | Mykychak Y.,Ukrainian Childrens Cardiac Center | Fedevych O.,Ukrainian Childrens Cardiac Center | Yemets I.,Ukrainian Childrens Cardiac Center
World Journal for Pediatric and Congenital Hearth Surgery | Year: 2014

Origin of the circumflex coronary artery (Cx) from the pulmonary arteries is an extremely rare anomaly. We describe a two-month-old female patient with anomalous origin of the Cx from the right pulmonary artery associated with coarctation of the aorta. Reimplantation of the anomalous Cx to the aorta and coarctation repair were performed. There were no postoperative complications, and the patient was discharged in satisfactory condition. © The Author(s) 2014. Source


Chasovskyi K.,Ukrainian Childrens Cardiac Center | Zhovnir V.,Ukrainian Childrens Cardiac Center | Vorobiova G.,Ukrainian Childrens Cardiac Center | Yemets I.,Ukrainian Childrens Cardiac Center
Annals of Thoracic Surgery | Year: 2016

Background The aim of this study was to evaluate the relationship between antiinflammatory cytokine interleukin (IL)-10 production and perioperative lactate concentrations and their impact on postoperative outcomes in neonates undergoing the arterial switch operation (ASO). Methods Between August 2010 and August 2012, 80 neonates with transposition of the great arteries (TGA) were enrolled. Serum IL-10 levels were measured immediately before and after cardiopulmonary bypass (CPB) on the first, third, and seventh days. Perioperative clinical data were collected prospectively. Results Patients underwent the ASO at a median age of 72 hours (4-144 hours). We found that serum IL-10 levels significantly correlated with a prolonged intensive care unit (ICU) length of stay (r = 0.3; p = 0.020) and duration of ventilation (r = 0.3; p = 0.017). Serum IL-10 levels on the first day after the surgical procedure had predictive value for a prolonged ICU stay (defined as an ICU stay >6 days postoperatively) by receiver operator curve analysis, with an area under the receiver operating characteristic (ROC) curve of 0.65 (p = 0.045). Logistic regression modeling indicated that serum lactate level (β = 2.7; p = 0.027), age at operation (β = -4.0; p = 0.007), and the nature (autologous or allogeneic) of blood products (β = -3.5; p = 0.030) used during CPB affected serum IL-10 levels. The strongest predictor of increased IL-10 on the first day after operation was a serum lactate level greater than 3 mmol/L measured after the surgical procedure on admission to the ICU, recording an odds ratio of 15.31. Serum lactate levels after operation and at admission to the ICU positively correlated with a prolonged ICU stay (r = 0.4; p = 0.007). Conclusions Elevated lactate levels are associated with increased IL-10 production on the first postoperative day. Excessive production of IL-10 on the first day after the surgical procedure is associated with a prolonged ICU stay. © 2016 The Society of Thoracic Surgeons. Source

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