title: Cerebral Protection During Mitral Valve Repair in a Patient With Moyamoya Syndrome.
abstract: In patients with moyamoya syndrome requiring heart surgery, the brain blood flow during the low perfusion state under cardiopulmonary bypass is a concern. We report on a successful mitral valve repair and tricuspid repair in a patient with moyamoya syndrome, performed using an integrated cerebral protection strategy with cerebral oxygen saturation monitoring, intraaortic balloon pumping, and cardiopulmonary bypass perfusion at a relatively high pressure. An integrated approach with a thorough discussion among cardiac surgeons, anesthesiologists, and perfusionists was invaluable to protect brain perfusion in a patient with moyamoya syndrome.
authors.affiliation: Division of Cardiovascular Surgery, Keio University, Tokyo, Japan. Electronic address: kazuma_okamoto@mac.com.
authors.forename: Kazuma
authors.initials: K
authors.lastname: Okamoto
authors.affiliation: Medical Engineering Center, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Arai
authors.affiliation: Division of Cardiovascular Surgery, Keio University, Tokyo, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Hirabayashi
authors.affiliation: Division of Cardiovascular Surgery, Keio University, Tokyo, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Morita
authors.affiliation: Division of Cardiovascular Surgery, Keio University, Tokyo, Japan.
authors.forename: Mikihiko
authors.initials: M
authors.lastname: Kudo
authors.affiliation: Division of Cardiovascular Surgery, Keio University, Tokyo, Japan.
authors.forename: Ryohei
authors.initials: R
authors.lastname: Yozu
authors.affiliation: Division of Cardiovascular Surgery, Keio University, Tokyo, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Shimizu
mesh_terms: D002545:Brain Ischemia / Q000517:prevention & control*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D009072:Moyamoya Disease / Q000150:complications*; D010477:Perfusion / Q000379:methods*