Hypothermic Circulatory Arrest????

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T

tdrother

Curious,

I will be undergoing Hypothermic Circulatory Arrest (HCA) during an up coming Jan. 9, 2007 ascending aortic resection and possible aortic valve replacement surgery. This surgery will repair a 5.0cm aortic aneurysm and possible replacemtn of my Bicuspid aortic valve. I was wondering if anyone has had HCA and did you notice any side-effects, both long and short term? Did you have any loss of brain function or memory?
Thanks for the help and god bless all of you.

Thanks,
Todd
 
Can't help you out but good luck with your upcoming surgery. I'm going to have to look up exactly what 'Hypothermic Circulatory Arrest' is. Of course, if I wait a little while, a few experts here will explain it quite well, I'm sure. :)
 
Sorry, unfortunately I can't help you with HCA. However, I just wanted to wish you all the best for your surgery on Jan 9th. There's lots of knowledge here so I'm sure somebody will have some information or advice for you. Take care.
 
Yep, had DHCA about 3 weeks ago for my 'Bentalls' to replace ascending aorta, aortic root and bicuspid aortic valve all in one go.....

I can't say ive had any issues from the procedure, i wasn't really up to much post surgery (no s**t!) but not sure if that was the DHCA or the bypass in general.

I still feel exactly the same and have the same interests although my 'motivation' to do unnecessary things isn't really there...ive got an insurance form i should have filled out to day that i just can't be bothered to do.

My sense of humour remains the same and i'm not any more grumpy or impatient than i was prior to surgery.

Probably the only 'body' thing i noticed post surgery was that my taste buds didn't work for a few days but i think that again was more to do with the bypass than the dhca.

I wouldn't have had the procedure done without DHCA as it removes the need to clamp the aorta near the great vessels which has the potential to trigger another anurysm later on....this was one of the biggest choices between the two surgeons i had interviewed....one wanted to cool me, open me up and take a look before replacing the aorta/valve separately and keeping the root, the other just straight off the bat said DHCA and replace it all, if you have bav and anurysm then the root is going to go eventually so just knock it all on the head straight away.

When the surgeons talk to you they have to give you the worst case scenario and let you know all the risks.....i remember that all the things i was told sounded awful but in the end the overall risk was 2%, 98% success....without the DHCA it was slightly less risk overall for the procedure but left me with a timebomb in the chest...

Hope my ramblings help in some way.
 
I have had a few cognitive issues since, mostly attention or lack of.

I think it is difficult to say whether dhca, pump , anesthesia or other.

I have been told, not sure how correct, that the time cooled is a factor, meaning the less the better.

if you search on pumphead you may find some stuff.
 
They used it on me when my aneurysm blew. To be honest, I was so close to death that any side effects I did have could have been from any number of things. Since then, I've had no problems to speak of out of the ordinary.
 
I had this surgery July 27th of this year and my aortic valve and root was replaced in addition to the aorta. I too was concerned about the possible short term memory loss etc, that sometimes occurs. I can say that I experienced none of that. Within 6 weeks my Surgeon told me all limitations on lifting etc were now lifted and that everything looked great. here at 41/2 months out I am still doing excellent, people cannot even tell what I had go through, I am pretty much normal in my activities. So far the only thing that has bothered me is a heart rate that runs a bit high so I am still on Toprol and they still have me on enalapril for blood pressure. Neither of these medications poses any problems for me.
Best of luck to you in your surgery.
 
Thanks to all that have responded. I would still like to hear from others on whether or not they had any complications with DHCA.
 
This is the most common means used for aortic arch repair, and a modified technique is usually used for valve replacements as well. Should a brief lack of bloodflow occur, the hypothermia (cold) helps keep the brain from being damaged.

There are sometimes some cognitive or emotional effects (pumphead), but they seem to go away over time. Another effect is that the patient sometimes gets spells of chills in the first few weeks, as the internal thermostat resets itself. An important factor in reducing pumphead is slow rewarming, which keeps the brain from suffering temporary anoxia, as it creates a very sudden demand for oxygen when it reaches a certain temperature. Slower rewarming slows the demand cycle, allowing the body's oxygen supply to catch up.

Best wishes,
 
tobagotwo said:
Another effect is that the patient sometimes gets spells of chills in the first few weeks, as the internal thermostat resets itself.
Click to expand...
Well i guess thats a symptom i have had then, only happened a couple of times and i wasn't unduely concerned or even linked the symptom to my surgery...just thought i'd got a bit of the shivvers....

Todd, as i said earlier, i personally think this is the only way to go for this type of surgery...the alternative is mild cooling and clamping the ascending aorta which will do just as good a job initially but has the potential of weakening the aorta where you were clamped and causing another aneurysm in the future.

I think my surgeon mentioned that even though blood flow is completely stopped sometimes they still stick a small supply into the brain from the bypass machine using another feed...havent spoken to my surgeon yet to ask him if he did this for me but will do and update.
 
Todd

Todd

I was sent home with a paper..Just dates, ect..but the Operative Procedure....stated that they did the deep hypothermia and circulatory arrest..during the procedure.....Just 3 lines..never thought much about it..figured they just really chilled me out.:D ....It will soon be 5 years since my valve surgery..so, memories of it..are fading..but, I do recall..not being able to talk on phone..to QAS..when they would ask me questions concerning my buying a Protime from them.. Like Names, numbers, ect..(Not my name, but others..like my Cardio, ect:p )...I think this was about 2 weeks post-op...........but things got better as the weeks went by..but, I think most people have this problem..The old Pumphead:p ....My Hubby always tells me. how in the world can you remember something that happened 30 years ago.:D So, it was not a long time memory lost...my Pumphead...Bonnie
 
Glad it all worked after putting it back together...

Glad it all worked after putting it back together...

Todd -

I had my OHS, including DHCA, just 7 short months ago. Fortunately, I don't believe I've had any aftereffects from the surgery (and I've had a fantastic recovery).

Months ago, after reading my post-op report (which was really fascinating), I called my surgeon to see how long I was on the heart/lung machine. I was told I was on the machine for 97 minutes and in DHCA for 11 minutes. BTW...when I was looking at surgeons, I made sure I chose one who was very comfortable with HCA.

Kristine
 
To be more clear, I was referring to the "cooling and clamping" scenario that Magic8ball described, where "standard" aortic valve surgery is concerned. In that instance, there is only brief interuption of bloodflow. I don't want to mislead folks.

However, the rewarming speed caution still applies.

Best wishes,
 
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