The heart surgery forum
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The heart surgery forum · Jan 1998
Clinical TrialPreoperative 3D-reconstructions of ultrafast-CT images for the planning of minimally invasive direct coronary artery bypass operation (MIDCAB).
The direct left internal mammary artery (LIMA) bypass to the left anterior descending (LAD) without the use of extracorporal circulation through a small anterolateral thoracotomy has become established among the minimally invasive techniques in cardiac surgery. Technical difficulties may occur in patients with an enlarged left ventricle and subsequent lateral positioning of the LAD, a small LAD, or a small LIMA. We used electron beam tomography (EBT) for preoperative visualization of the topographical structures to seek out patients with potential technical difficulties. ⋯ For minimally invasive direct coronary artery bypass (MIDCAB) the topography of the LIMA, LAD and intercostal spaces is of major importance. Using the ECG-triggered EBT with subsequent three-dimensional reconstruction these relationships can be visualized. This enables an individual planning of the operation and a minimalization of the skin incision.
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The heart surgery forum · Jan 1998
Comparative Study Clinical TrialClinical evaluation of the on-line Sensicath blood gas monitoring system.
Blood gas analysis is an integral part of the management of open heart surgery and post-surgical intensive care patients. This study was conducted to compare the results of on-line blood gas analysis using the new Sensicath (SC) optical sensor technology against standard blood gas assay. ⋯ In summary, this study found the Sensicath to be an accurate, useful tool which permits immediate blood gas analysis without blood exposure and constitutes an advance in the field of intensive care monitoring.
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Repeat cardiac surgery represents eight to twenty five percent of cardiac surgical procedures. Catastrophic hemorrhage is a known complication of repeat sternotomy. A number of techniques have been described to reduce the incidence of injury to the heart and mediastinal structures during reoperation. This paper reports a new endoscopic technique to visualize and lyse the adhesions between the sternum and heart prior to repeat median sternotomy. ⋯ The Endoscopic Redo Sternotomy Retractor provides excellent visualization of all retrosternal structures and adhesions allowing safe and meticulous dissection prior to sternal opening.