By Constantine Mavroudis, Carl Lewis Backer, Rachid F. Idriss
The raison d’etre for a brand new atlas of congenital middle surgical procedure is predicated at the truth that the distinctiveness has gone through a number of adjustments within the previous couple of years leading to more advantageous options and new operations. The sheer variety of new tactics and the mandatory attendant technical talents to effectively entire an operation has turn into a problem to grasp, in particular for citizens who're pursuing a occupation in congenital center surgical procedure. whereas the options that we're espousing are often our personal, there's a good deal of similarity among overseas facilities because of the impact of video displays, manuscript guides, and bankruptcy stories. We as a result think that the recommendations which are illustrated during this atlas usually are just like the innovations which are taught all over the world to citizens and fellows. The atlas is prepared usually by way of ailments and approaches pertaining thereto. basic sections contain cannulation suggestions and palliative systems, respectively. a different part depicts tough difficulties within the kind of medical vignettes that can come up in the course of cardiopulmonary skip resembling: diminished venous go back, undiagnosed patent ductus arteriosus, and technical error resulting in hemodynamic problems. The reader is prompt to use measures that would bring about solution of those difficulties. we've selected tactics, which hide the breadth of congenital middle surgical procedure. whereas probably now not completely inclusive, the reader will locate the better majority of congenital middle techniques illustrated and defined during this text.
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Additional info for Atlas of Pediatric Cardiac Surgery
11 shows the completed dissection of a patient with PAB in preparation for the excision and direct anastomosis technique. After cardiopulmonary bypass, the PAB is removed and the surgeon is shown removing the cuff of pulmonary artery wall (dotted lines) that was involved in the PAB (Fig. 12). 13 shows the completion of the banded segmental resection, leaving uninvolved native proximal and distal pulmonary artery tissue. The reanastomosis is performed by interrupted suture technique, starting at the posterior wall (Fig.
When the pulmonary artery has not been detached from the heart at a prior operation, aortic cross-clamping and cardioplegic arrest are employed to prevent air embolism. 41 shows these maneuvers while the pulmonary artery is transected. The pulmonary valve is sutured closed (not shown) and the proximal pulmonary artery is oversewn. The distal pulmonary artery is isolated using a pericardial or synthetic patch (Fig. 42a, b). The aortic cross-clamp can then be removed in preparation for the subsequent part of the operation.
World J Pediatr Congenit Heart Surg. 2013;4:85–97. ) C. 1 Pulmonary Artery Band Pulmonary artery band (PAB) is performed through a thoracotomy or median sternotomy, depending on surgeon’s preference. The rationale for using a thoracotomy approach has been to facilitate median sternotomy for the eventual definitive repair. Over the past 10 years, however, redo sternotomy techniques have improved and are no longer a risk factor for reoperations. Most surgeons now prefer a median sternotomy approach for PAB because of the improved exposure for anatomic and physiologic manipulations.
Atlas of Pediatric Cardiac Surgery by Constantine Mavroudis, Carl Lewis Backer, Rachid F. Idriss