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Pulmonary thromboendarterectomy (PTE) are frequently accomplished at UCSD. This typically involves an extraordinary intervention that requires total circulatory arrest and this is accomplished under deep hypothermia (1 TC). The intraoperative cardiac, pulmonary, hemodynamic, and biochemical responses to (PTE) and deep hypothermic circulatory arrest (DHCA) have not been well described. One reason for this is that in institutions other than UCSD, these procedures are rarely performed. Since we perform more than 150 PTEs with DHCA per year here at UCSD, I see a wonderful opportunity to collect, analyze, and report data collected in the perioperative period. Thus, I am collaborating with the pulmonologists and cardiac surgeons, setting up an efficient clinical research system designed to help us better understand the perioperative events associated with PTE and DHCA and to investigate the biochemistry and physiology of the human organism under extreme, but controlled, conditions. In an integrated effort involving close interdepartmental collaborations, we currently have several ongoing projects. My clinical investigative work has revolved around this PTE program. We have begun an investigation of the arterial line function (femoral versus radial) during PTE (32 patients with total circulatory arrest. We also have an ongoing project with the Pulmonary Department, studying the effect of steroid administration to PTE patients on systemic inflammatory response (cytokines release) and protein S 100. I am also collaborating with Dr. Waltman of Cardiology studying the rapid cardiac remodeling following PTE using transesophageal echocardiography
Publications (Selected From 29 Publications)
Manecke GR Jr. Pro: The FloTrac device should be used to follow cardiac output in cardiac surgical patients. J Cardiothorac Vasc Anesth. 24:706-8, 2010
Manecke GR Jr, Vezina DP. Perioperative transthoracic echocardiography: "universal acid"?J Cardiothorac Vasc Anesth. 2009 Aug;23(4):447-9.
Mayer J, Boldt J, Poland R, Peterson A, Manecke GR Jr.Continuous arterial pressure waveform-based cardiac output using the FloTrac/Vigileo: a review and meta-analysis. J Cardiothorac Vasc Anesth. 23:401-6, 2009
Davis BA, Manecke GR Jr, Madani MM.New cardiac mass during cardiopulmonary bypass.J Cardiothorac Vasc Anesth. 22:786-7,2008
Manecke GR Jr, Parimucha M, Stratmann G, Wilson WC, Roth DM, Auger WR, Kerr KM, Jamieson SW, Kapelanski DP, Mitchell MM Deep hypothermic circulatory arrest and the femoral-to-radial arterial pressure gradient. J Cardiothorac Vasc Anesth. 18:175-9,2004
Manecke GR Jr, Ingersoll-Weng E, Thistlethwaite PA.Dexmedetomidine and asystole. Anesthesiology 101:1479-80. 2004 .
Manecke GR Jr, Kotzur A, Atkins G, Fedullo PF, Auger WR, Kapelanski DP, Jamieson SW. Massive pulmonary hemorrhage after pulmonary thromboendarterectomy. Anesth Analg.;99:672-5 2004.
Ingersoll-Weng E, Manecke GR Jr, Thistlethwaite PA.Dexmedetomidine and cardiac arrest. Anesthesiology.;100:738-9,2004.