Siavosh Khonsari's Cardiac Surgery: Safeguards and Pitfalls in Operative PDF

By Siavosh Khonsari

ISBN-10: 0781769507

ISBN-13: 9780781769501

Now in its Fourth variation, this article is a pragmatic, seriously illustrated consultant to systems in cardiac surgical procedure. Chapters disguise received and congenital ailments and comprise surgical anatomy, surgical exposures, and step by step procedural information. The authors point out pitfalls with a chance signal and flag issues of exact curiosity with "NB" (Nota Bene).

This version has contributions from Abbas Ardehali, MD, FACS, the director of the UCLA center, heart-lung, and lung transplant application. Highlights comprise a brand new bankruptcy on middle transplantation. additionally incorporated are updates in minimally invasive surgical procedure and vascular and endovascular surgery.

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Extra resources for Cardiac Surgery: Safeguards and Pitfalls in Operative Technique

Sample text

An appropriately sized right-angled cannula is introduced, and the purse-string suture is secured around the cannula. Azygous vein 1 cm Superior Vena Cava The pericardial reflection on the superior vena cava is divided to maximally free up the great vein. A rectangular or oval purse-string suture of 5-0 or 4-0 Prolene is placed in the adventitia of the superior vena cava close to its junction with the innominate vein. The segment of the superior vena cava with the purse-string suture is excluded with an atraumatic side-biting clamp.

2-6). Injury to the Right Pulmonary Artery On rare occasions when the right pulmonary artery takes a more caudal course, it may be injured during dissection around the aorta. If such a problem arises, it is best to control the bleeding by packing the area and to correct the lesion when the heart is decompressed on full cardiopulmonary bypass. The right pulmonary artery can also be injured during dissection of the superior vena cava, especially when passing a tape around this vessel (Fig. 2-7). Dissection Around the Cavae Dissection required to pass umbilical tapes around the venae cavae in preparation for total cardiopulmonary bypass may be tedious and occasionally may result in 21 22 SECTION I • General Considerations FIG 2-3.

Technique The femoral vein can be cannulated percutaneously. We prefer to expose the femoral vein through a small incision below the inguinal ligament. A purse-string suture of 5-0 Prolene is placed on the anterior aspect of the common femoral vein. A long venous cannula with multiple side holes is placed by first passing a guide wire through a needle puncture in the middle of the purse-string stitch. The cannula mounted on a tapered dilator sheath is gently advanced over the guide wire and positioned either in the right atrium or inferior vena cava depending on the procedure to be performed under transesophageal echocardiographic control.

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Cardiac Surgery: Safeguards and Pitfalls in Operative Technique by Siavosh Khonsari


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