Cardiac Surgery E-Book , livre ebook

CARDIAC SURGERY
Operative Technique
Second Edition

Donald B. Doty, M.D.

John R. Doty, M.D.
Division of Cardiovascular and Thoracic Surgery, Intermountain Medical Center, Salt Lake City, Utah

Jill Rhead, MA, CMI, FAMI

Christy Krames, MA, CMI, FAMI
Table of Contents
Cover image
Title page
Copyright
Dedication
Preface
Part I: Basic Considerations
Chapter 1: Cardiac anatomy
Chapter 2: Setup for cardiac surgery
Incision
Control of venae cavae
Cannulation of the ascending aorta
Cannulation of the femoral artery
Cannulation of the veins
Cervical venous cannulation and left heart venting
Femoral cannulation for cardiopulmonary bypass
Cannulation for aortic operations
Cannulation of the axillary artery
Myocardial protection
Minimally invasive approaches in cardiac surgery
Chapter 3: Circulatory support
Cannulation for left and right heart bypass
Percutaneous ventricular assist device
Left ventricular assist device
Total artificial heart
Part II: Septal Defects
Chapter 4: Atrial and atrioventricular septal defects
Morphology
Atrial septal defect, secundum type
Partial atrioventricular septal defect
Complete atrioventricular septal defect
Re-repair of partial atrioventricular septal defect
Chapter 5: Ventricular septal defect
Morphology
Transatrial approach
Transventricular approach
Doubly committed subarterial ventricular septal defect
Chapter 6: Aortopulmonary septal defect
Morphology
Aortopulmonary septal defect—type I
Aortopulmonary septal defect—types II and III
Part III: Anomalies of Pulmonary Venous Connection
Chapter 7: Partial anomalous pulmonary venous connection
Morphology
Right superior pulmonary vein to superior vena cava with sinus venosus atrial septal defect
Right pulmonary vein to inferior vena cava (scimitar syndrome)
Left pulmonary vein to innominate vein
Chapter 8: Total anomalous pulmonary venous connection
Morphology
Cardiac type
Supracardiac type
Infracardiac type
Chapter 9: Cor triatriatum
Morphology
Part IV: Right Heart Valve Lesions (Congenital)
Chapter 10: Pulmonary valve stenosis
Morphology
Pulmonary valvotomy
Chapter 11: Tetralogy of Fallot
Morphology
Right atrial approach
Right ventricular approach
Chapter 12: Right ventricle–pulmonary artery discontinuity
Morphology
Closure of ventricular septal defect
Right ventricle–to–pulmonary artery conduit
Chapter 13: Ebstein’s anomaly
Morphology
Tricuspid repair or replacement
Rotation valvuloplasty-annuloplasty (carpentier method)
Part V: Left Heart Valve Lesions (Congenital)
Chapter 14: Aortic valve stenosis
Morphology
Aortic valvotomy
Chapter 15: Supravalvular aortic stenosis
Morphology
Extended aortoplasty
Chapter 16: Subvalvular aortic stenosis
Localized fibromuscular type
Diffuse or tunnel type
Chapter 17: Left ventricular outflow tract obstruction
Types of operations
Posterior enlargement of left ventricular outflow tract: Manougian and Nunez operations
Posterior enlargement of left ventricular outflow tract: Nicks operation
Anterior enlargement of left ventricular outflow tract: Konno-Rastan aortoventriculoplasty
Anterior enlargement of left ventricular outflow tract: Vouhe aortoventriculoplasty
Apex left ventricle–to–aorta conduit
Chapter 18: Sinus of Valsalva aneurysm and fistula
Morphology
Yacoub aortoplasty
Part VI: Single Ventricle
Chapter 19: Septation of the univentricular heart
Morphology
Chapter 20: Modified Fontan procedure
Morphology
Total cavopulmonary connection/fenestrated atrial septum
Chapter 21: Hypoplastic left heart syndrome
Morphology
Norwood operation
Part VII: Malposition of the Great Arteries
Chapter 22: Transposition of the great arteries
Morphology
Arterial repair
Atrial repair: Senning operation
Atrial repair: Mustard procedure
Chapter 23: Transposition with ventricular inversion (corrected transposition)
Morphology
Correction of ventricular septal defect
Correction of pulmonary outflow tract obstruction
Chapter 24: Double-outlet right ventricle
Morphology
Subaortic ventricular septal defect
Subpulmonary ventricular septal defect (Taussig-Bing malformation)
Part VIII: Thoracic Arteries and Veins (Congenital)
Chapter 25: Coronary artery anomaly
Morphology
Anomalous origin of left coronary artery: lateral approach
Anomalous origin of left coronary artery: anterior approach (Takeuhi operation)
Coronary artery–to–cardiac chamber fistula
Chapter 26: Patent ductus arteriosus
Morphology
Chapter 27: Coarctation of the aorta
Morphology
Extraanatomic bypass for residual stenosis following repair of coarctation of the aorta
Chapter 28: Interrupted aortic arch
Morphology
Chapter 29: Vascular ring and sling
Morphology
Double aortic arch
Right aortic arch with retroesophageal left subclavian artery and left ligamentum arteriosum
Left aortic arch with retroesophageal right subclavian artery originating as fourth branch of the arch
Tracheal compression by innominate artery
Vascular sling
Chapter 30: Palliative operations
Subclavian artery–pulmonary artery anastomosis
Ascending aorta–right pulmonary artery anastomosis
Superior vena cava–right pulmonary artery anastomosis
Atrial septectomy
Banding of pulmonary artery
Removal of pulmonary artery band
Part IX: Valve Lesions (Acquired)
Chapter 31: Aortic valve replacement
Morphology
Valve excision and débridement
Continuous suture technique
Interrupted suture technique
Aortic allograft: Kirklin/Barrett-Boyes 120-degree rotation technique
Aortic allograft: Ross intact noncoronary sinus technique
Aortic allograft: aortic root enlargement technique
Aortic allograft: aortic root enlargement with mitral valve
Aortic allograft: miniroot (inclusion) technique
Aortic allograft: complete root (freestanding) technique
Stentless porcine xenograft: subcoronary valve replacement
Stentless equine xenograft: subcoronary aortic valve replacement
Stentless porcine xenograft: aortic root replacement
Pulmonary autograft (Ross procedure)
Pulmonary autograft: dilated aortic annulus
Pulmonary autograft: dilation or aneurysm of the ascending aorta
Pulmonary autograft: small aortic root (Ross-Konno procedure)
Apical-aortic conduit
Transcatheter aortic valve implantation
Chapter 32: Mitral valve reconstruction
Morphology
Introduction to mitral valve reconstructive techniques
Annuloplasty techniques
Posterior leaflet excision and repair, with or without annular support
Ring annuloplasty
Sliding valvuloplasty with remodeling annuloplasty
Anterior leaflet augmentation
Repair of elongated or ruptured chordae tendineae
Chordae tendineae replacement and chordal transfer techniques
Chapter 33: Mitral valve replacement
Morphology
Incisions
Preservation of chordae tendineae
Interrupted suture technique
Continuous suture technique
Mitral valve homograft
Calcified mitral annulus
Chapter 34: Tricuspid valve reconstruction
Ring annuloplasty (Carpentier operation)
Suture annuloplasty (DeVega operation)
Chapter 35: Tricuspid valve replacement
Morphology
Tricuspid valve replacement with stented bioprosthesis
Tricuspid valve replacement with mitral homograft
Part X: Ischemic Heart Disease
Chapter 36: Coronary artery bypass graft
Preparation of saphenous vein graft
Endoscopic saphenous vein harvest
Saphenous vein–coronary artery (distal) anastomosis
Aorta–saphenous vein (proximal) anastomosis
Preparation of the internal mammary artery pedicle
Internal mammary artery–coronary artery anastomosis
Right internal mammary artery–circumflex coronary artery bypass
Radial artery bypass grafts
Open radial artery harvest
Endoscopic radial artery harvest
All-arterial revascularization
Coronary thromboendarterectomy
Minimally invasive direct coronary artery bypass (MIDCAB)
Chapter 37: Ventricular aneurysm
Anterior left ventricular aneurysm
Morphology
Endoaneurysmorrhaphy technique
Ventricular aneurysm: mitral valve replacement
Anterior septal rupture
Posterior septal rupture
Part XI: Thoracic Arteries and Veins (Acquired)
Chapter 38: Aortic aneurysm
Morphology
Cannulation strategies for aortic operations
Replacement of ascending aorta with prosthetic graft
Replacement of ascending aorta and aortic root
Aortic arch
Ascending aorta and hemiarch replacement with arch thromboendarterectomy
Valve-sparing aortic root replacement-reimplantation technique (Yacoub/David II operation)
Valve-sparing aortic root replacement with Valsalva graft resuspension technique (David I operation)
Aortic ar