Download Cardiac Surgery: Safeguards and Pitfalls in Operative by Siavosh Khonsari, Colleen Flint Sintek PDF
By Siavosh Khonsari, Colleen Flint Sintek
Now in its Fourth version, this article is a pragmatic, seriously illustrated consultant to tactics in cardiac surgical procedure. Chapters disguise received and congenital illnesses and contain surgical anatomy, surgical exposures, and step by step procedural info. The authors point out pitfalls with a risk signal and flag issues of distinct curiosity with "NB" (Nota Bene). This variation has contributions from Abbas Ardehali, MD, FACS, the director of the UCLA middle, heart-lung, and lung transplant application. Highlights contain a brand new bankruptcy on middle transplantation. additionally incorporated are updates in minimally invasive surgical procedure and vascular and endovascular surgical procedure.
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Extra info for Cardiac Surgery: Safeguards and Pitfalls in Operative Technique, 4th Edition
Maintaining Uniform Cooling Uniform cooling of the myocardium by infusion of cold cardioplegic solution is an integral part of myocardial protection. Temperature probes in various parts of the septum and ventricular wall may be used to monitor myocardial temperature during the course of the surgery. Inadequate Protection of the Right Ventricle Despite all precautions to keep the heart cool, the anterior surface of the heart tends to rewarm because of the ambient air temperature and the heat radiated from the operating room lights.
The pectoralis major muscle is dissected and divided along its fibers and the deltopectoral fascia is incised. The axillary vein and then the artery are encountered. The brachial plexus is located cephalad to the vascular bundle and must be identified and protected when the axillary artery is to be encircled (Fig. 2-14). Injury to Brachial Plexus Traction and manipulation of brachial plexus should be avoided. Electrocautery should not be used close to the brachial plexus to prevent nerve injury.
Left Ventricular Apical Venting The apex of the left ventricle provides a satisfactory and accessible site for venting and is particularly effective for removal of air trapped in the ventricular cavity. However, it is rarely used currently. Its relevance becomes important when left ventricular venting is necessary before repeat sternotomy (see Repeat Sternotomy section in Chapter 1). Technique The region of the left ventricular apex may be thin walled and covered by fat. The site chosen for insertion of the vent must be well away from the branches of the coronary arteries and free of loose myocardial fat.