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 forte has passed through a number of adjustments within the previous few years leading to more suitable ideas and new operations. The sheer variety of new systems and the mandatory attendant technical abilities to effectively whole an operation has turn into a problem to grasp, particularly for citizens who're pursuing a profession in congenital center surgical procedure. whereas the recommendations that we're espousing are normally our personal, there's a good deal of similarity among overseas facilities as a result of the effect of video displays, manuscript guides, and bankruptcy studies. We as a result think that the options which are illustrated during this atlas usually are just like the ideas which are taught around the globe to citizens and fellows. The atlas is geared up regularly by means of illnesses and methods pertaining thereto. common sections contain cannulation recommendations and palliative strategies, respectively. a unique part depicts tough difficulties within the type of scientific vignettes that can come up in the course of cardiopulmonary pass similar to: lowered venous go back, undiagnosed patent ductus arteriosus, and technical blunders resulting in hemodynamic problems. The reader is recommended to use measures that may bring about solution of those difficulties. we have now selected systems, which conceal the breadth of congenital center surgical procedure. whereas probably no longer absolutely inclusive, the reader will locate the larger majority of congenital middle approaches illustrated and defined during this text.
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Extra resources for Atlas of Pediatric Cardiac Surgery
39 Reproduced from Backer CL, Mavroudis C. Palliative operations. In: Mavroudis C, Backer C, editors. Pediatric cardiac surgery, 4th ed. Hoboken: Wiley-Blackwell; 2013. p. 155–68. ) Fig. 45 Fig. 46 Fig. 1 shows the relational anatomy of patent ductus arteriosus (PDA), highlighting the patent ductus, the recurrent laryngeal nerve, and the directional left-to-right-to-left shunt. The dotted lines represent the continuation of the descending aorta posterior to the left pulmonary artery. 2 shows a transmediastinal exposure of a PDA in relation to the aorta and pulmonary artery.
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. It is therefore important to perform a comprehensive dissection in order to avoid this potential complication.
Mavroudis Fig. 3 Fig. 2 2 Palliation Techniques 21 Fig. 6 Fig. 4 Fig. 7 Fig. 5 Fig. 8 22 C. 1 Pulmonary Artery Band Takedown and Repair Pulmonary artery banding takedown usually requires cardiopulmonary bypass, Teflon PAB removal, and repair by either direct anastomosis or patch technique. Each technique has its advantages and disadvantages and is illustrated. Fig. 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.