By Constantine Mavroudis, Carl Lewis Backer, Rachid F. Idriss
The raison d’etre for a brand new atlas of congenital middle surgical procedure relies at the truth that the distinctiveness has passed through a number of alterations within the previous few years leading to superior ideas and new operations. The sheer variety of new strategies and the necessary attendant technical talents to effectively whole an operation has turn into a problem to grasp, specially for citizens who're pursuing a profession in congenital center surgical procedure. whereas the thoughts that we're espousing are more often than not our personal, there's a good deal of similarity among foreign facilities because of the effect of video displays, manuscript courses, and bankruptcy studies. We accordingly think that the innovations which are illustrated during this atlas usually are just like the options which are taught around the world to citizens and fellows. The atlas is equipped mostly through illnesses and systems pertaining thereto. basic sections contain cannulation recommendations and palliative techniques, respectively. a distinct part depicts tricky difficulties within the type of medical vignettes that could come up in the course of cardiopulmonary pass equivalent to: reduced venous go back, undiagnosed patent ductus arteriosus, and technical mistakes resulting in hemodynamic issues. The reader is steered to use measures that might result in solution of those difficulties. we have now selected methods, which hide the breadth of congenital center surgical procedure. whereas might be now not completely inclusive, the reader will locate the larger majority of congenital center strategies illustrated and defined during this text.
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Additional info for Atlas of Pediatric Cardiac Surgery
The anastomosis is then initiated using polypropylene running suture technique (Fig. 23). 24 shows the performance of the posterior anastomosis, which will end near the apex of the arteriotomy. 26 shows the completed proximal suture line. The clamp is left applied to the systemic artery because if it were removed from the artery and applied to the shunt material, an unwanted clot could form at the anastomotic site, causing shunt thrombosis. 26, or by a side-biting clamp of the right pulmonary artery (not shown).
31 2 Palliation Techniques 29 Fig. 33 Fig. 3 C. 37 are provided to show the classic Blalock-Taussig and Waterston shunts. The Blalock-Taussig shunt, otherwise known as the Blalock-Taussig-Thomas shunt to recognize the pioneering laboratory work of Vivian Thomas at Johns Hopkins University during this golden era of heart surgery, was initially developed to create an animal model of pulmonary hypertension. 34, revolutionized the field of congenital heart surgery and paved the way for the development of systemic-topulmonary artery shunts that could be applied to very small infants, such as the Waterston shunt (Figs.
4a). The ligamentum is carefully dissected, taking great care not to injure the recurrent laryngeal nerve, which originates from the vagus nerve and then recurs up the tracheoesophageal groove posteriorly. After the ligamentum is identified, it can be either doubly ligated and divided or doubly clamped and divided, with oversewing of the two stumps (Fig. 4b). If the ligamentum is doubly ligated, these ligatures should be reinforced with Prolene (Ethicon; Somerville, NJ, USA) sutures. Occasionally the ligamentum will have a small patent lumen that is not apparent preoperatively.