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

Federico Pascucci, MD; Tommaso Donati, MD; Giovanni Tinelli, MD, PhD; Gabriella Arlotta, MD; Antonio Luparelli, MD; Yamume Tshomba, MD

Journal of Vascular Surgery Cases and Innovative Techniques (Sep 2023)

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

Federico Pascucci, MD,
Tommaso Donati, MD,
Giovanni Tinelli, MD, PhD,
Gabriella Arlotta, MD,
Antonio Luparelli, MD,
Yamume Tshomba, MD

Affiliations

Federico Pascucci, MD: Vascular Surgery Unit, Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy; Correspondence: Federico Pascucci, MD, Vascular Surgery Unit, Fondazione Policlinico Universitario A Gemelli IRCCS – Largo Agostino Gemelli, Rome 00168, Italy
Tommaso Donati, MD: Vascular Surgery Unit, Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
Giovanni Tinelli, MD, PhD: Vascular Surgery Unit, Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
Gabriella Arlotta, MD: Cardiac Anesthesia and Intensive Care Unit, Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
Antonio Luparelli, MD: Vascular Surgery Unit, Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
Yamume Tshomba, MD: Vascular Surgery Unit, Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy

Journal volume & issue: Vol. 9, no. 3
p. 101276

Abstract

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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.

Published in Journal of Vascular Surgery Cases and Innovative Techniques

ISSN: 2468-4287 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Surgery; Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.sciencedirect.com/journal/journal-of-vascular-surgery-cases-innovations-and-techniques

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