By Constantine Mavroudis, Carl Lewis Backer, Rachid F. Idriss
The raison d’etre for a brand new atlas of congenital center surgical procedure is predicated at the truth that the area of expertise has gone through a variety of alterations within the previous few years leading to enhanced recommendations and new operations. The sheer variety of new techniques and the necessary attendant technical abilities to effectively entire an operation has turn into a problem to grasp, in particular for citizens who're pursuing a occupation in congenital middle surgical procedure. whereas the options that we're espousing are regularly our personal, there's a good deal of similarity among overseas facilities because of the effect of video displays, manuscript guides, and bankruptcy reports. We accordingly think that the innovations which are illustrated during this atlas usually are just like the innovations which are taught around the globe to citizens and fellows. The atlas is prepared regularly by means of ailments and tactics pertaining thereto. basic sections contain cannulation suggestions and palliative methods, respectively. a unique part depicts tough difficulties within the type of scientific vignettes which could come up in the course of cardiopulmonary skip resembling: reduced venous go back, undiagnosed patent ductus arteriosus, and technical blunders resulting in hemodynamic problems. The reader is advised to use measures that would result in solution of those difficulties. we've got selected strategies, which conceal the breadth of congenital middle surgical procedure. whereas maybe no longer completely inclusive, the reader will locate the higher majority of congenital center strategies illustrated and defined during this text.
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4 Vascular Rings, Tracheoplasty, and Pulmonary Artery Sling Occasionally, the base of the Kommerell diverticulum is friable (because of long-standing aneurysmal formation) and does not appear to be amenable to primary suture closure. 5c. 6a, b. 6a shows the preoperative situation, with the esophagus compressed posteriorly a Fig. 4 51 by the left subclavian artery and constricted by the ring formed by the right aortic arch and left ligamentum. The trachea is significantly compressed on its rightward aspect by being within the confines of the ring.
27) within the pulmonary artery and the PTFE shunt. 28. The clamps are then removed simultaneously, and the bleeding is controlled (Fig. 29). Fig. 21 Fig. 20 26 C. Mavroudis Fig. 22 Fig. 24 Fig. 25 Fig. 23 2 Palliation Techniques 27 Fig. 28 Fig. 26 Fig. 29 Fig. 1 C. Mavroudis Takedown of a Modiﬁed Blalock-Taussig Shunt Takedown of an established systemic-to-pulmonary artery shunt is a necessary part of intracardiac repair after palliation. In general, the prosthetic material needs to be identified, interrupted, and divided to prevent superior tenting of the pulmonary artery during subsequent somatic growth.
In general, the PAB is tightened to achieve a distal pulmonary artery pressure that is 50 % of the systemic pressure (Fig. 8). It is important to suture the tightened PAB to the adventitia of the pulmonary artery (Fig. 9) in order to prevent migration distally, which can cause right or left pulmonary artery stenosis. 10 shows the PAB in place. The inset demonstrates stepwise suture tightening of the band to achieve the desired result. Fig. 1 C. org © Springer-Verlag London 2015 C. L. 1007/978-1-4471-5319-1_2 19 20 C.
Atlas of Pediatric Cardiac Surgery by Constantine Mavroudis, Carl Lewis Backer, Rachid F. Idriss