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E-grāmata: Endoscopic Mitral Valve Surgery: Handbook of Minimal-invasive Cardiac Surgery

  • Formāts: 145 pages
  • Izdošanas datums: 23-Dec-2011
  • Izdevniecība: De Gruyter
  • Valoda: eng
  • ISBN-13: 9783110254457
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Endoscopic Mitral Valve Surgery: Handbook of Minimal-invasive Cardiac SurgeryPalielināt
  • Formāts: 145 pages
  • Izdošanas datums: 23-Dec-2011
  • Izdevniecība: De Gruyter
  • Valoda: eng
  • ISBN-13: 9783110254457
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The book describes first all practical steps necessary in a clinic from the idea of the introduction of the minimally-invasive mitral valve surgery up to practical realization of the operation program. An extensive and detailed representation of the reconstruction technologies possible today as well as the specific features of the endoscopic application allow quick learning of the surgical technology. Informative pictures as well as videosequences of the most frequent findings and the accompanying reconstruction technologies underline the practical orientation of the book.

Ralf Krakor, Klinikum Dortmund, Deutschland.
Preface ix
1 Introduction 1(18)
1.1 General thoughts on endoscopic surgery
1(4)
1.1.1 The philosophy
1(2)
The ideas behind it
1(1)
Complexity
2(1)
Experience
2(1)
Valve repair – frequency of valve replacements
3(1)
1.1.2 The team
3(1)
1.1.3 Holding out
4(1)
1.2 How to start an endoscopic program
5(14)
1.2.1 Starting conditions for endoscopic mitral valve surgery
6(1)
1.2.2 Patient-related arguments
7(4)
Prognosis
7(2)
Need for blood transfusion
9(1)
Wound-healing disturbances
9(1)
Cosmetic reason
10(1)
1.2.3 Hospital-related arguments
11(2)
Marketing
11(1)
Economic reasons
11(2)
1.2.4 Patient selection
13(2)
1.2.5 Teaching course
15(1)
1.2.6 Starter kit for endoscopic mitral valve surgery
15(1)
1.2.7 Overview
16(3)
2 Anesthesiology and pain management 19(4)
2.1 Intubation and ventilation
19(1)
2.2 Pain management
19(4)
3 Technical prerequisites 23(14)
3.1 Cannulas and extracorporeal circulation
23(5)
3.1.1 Arterial cannulas (retrograde perfusion)
23(1)
3.1.2 Arterial cannulas (antegrade perfusion)
24(1)
3.1.3 Venous cannulas
25(3)
3.1.4 Extracorporeal circulation
28(1)
3.2 Accessories
28(2)
3.2.1 Soft-tissue retractor
28(1)
3.2.2 Arms for videoscopic camera and atrial retractor
29(1)
3.3 Instruments
30(3)
3.3.1 Atrial hook
33(1)
3.4 Sutures
33(4)
4 Preparations 37(24)
4.1 Arterial and venous cannulation
37(6)
4.1.1 Femoral vessel cannulation after preparation
37(3)
4.1.2 Direct cannulation of the ascending aorta
40(3)
4.2 Mini-thoracotomy
43(4)
4.3 Ports
47(1)
4.4 Videoscopy
48(3)
4.4.1 The wrinkle
49(1)
4.4.2 The diameter
50(1)
4.4.3 The monitor picture
50(1)
4.4.4 Additional helpful details
50(1)
4.5 Cardioplegia
51(5)
4.5.1 Use of cardioplegia
51(4)
4.5.2 Operations under fibrillation
55(1)
4.6 Aortic clamping
56(5)
4.6.1 Endoclamping
56(1)
4.6.2 The Chitwood technique
57(2)
4.6.3 Complications
59(2)
5 Valve repair techniques 61(38)
5.1 Quadrangular resection
61(7)
5.1.1 Pathological anatomy
61(1)
5.1.2 Theoretical remarks
62(1)
5.1.3 Practical realization
62(6)
Identifying the prolapse
62(1)
Cutting out of the prolapse
63(2)
Narrowing of the annulus
65(1)
Closure of the gap
66(2)
5.2 Triangular resection
68(3)
5.2.1 Pathological anatomy
68(1)
5.2.2 Theoretical remarks
69(1)
5.2.3 Practical realization
69(2)
Identifying the prolapse
69(1)
Cutting out the prolapse
70(1)
Narrowing of the annulus
70(1)
Closure of the gap
71(1)
5.3 Sliding technique
71(7)
5.3.1 Pathological anatomy
71(1)
5.3.2 Theoretical remarks
72(1)
5.3.3 Practical realization
73(5)
Identifying the diseased parts
73(1)
Cutting out of diseased part(s)
74(2)
Retiring the leaflet
76(1)
Narrowing of the annulus
77(1)
Sliding and refixation
77(1)
5.4 Neochords - preformed loops
78(7)
5.4.1 Pathological anatomy
79(2)
5.4.2 Theoretical remarks
81(2)
5.4.3 Practical realization
83(2)
Identifying the diseased parts
83(1)
Measurement of the chordae length
83(2)
Implantation of preformed loops
85(1)
5.5 Neochords - flexible length
85(6)
5.5.1 Pathological anatomy
86(1)
5.5.2 Theoretical remarks
86(1)
5.5.3 Practical realization
87(4)
Identifying the diseased parts
87(1)
Measurement of the chorda length
87(1)
Implantation of flexible chords
87(4)
5.6 Artificial rings
91(4)
5.6.1 Theoretical remarks
91(1)
5.6.2 Implantation technique
92(2)
5.6.3 Complications
94(1)
5.7 Emergency exit
95(4)
5.7.1 Theoretical remarks
95(1)
5.7.2 Practical performing
96(3)
6 Tips and tricks 99(14)
6.1 Perfusion's challenge
99(1)
6.2 Diaphragm's obesity
100(1)
6.3 View's hurdles
101(2)
6.4 Instruments' versatility
103(3)
6.5 The knot pusher's independent existence
106(3)
6.6 Managing bleeding
109(4)
6.6.1 Bleeding of ascending aorta
109(1)
6.6.2 Bleeding of the left atrial incision
110(1)
6.6.3 Bleeding of the left atrial appendage
110(1)
6.6.4 Injury of the right pulmonary main stem
110(1)
6.6.5 Injury of the right mammary artery
111(1)
6.6.6 Bleeding of the intercostal artery
111(2)
7 Additional procedures 113(20)
7.1 Left atrial ablation
113(8)
7.1.1 Endocardial ablation
113(2)
7.1.2 Epicardial ablation - pulmonary veins clamp technique
115(1)
7.1.3 Epicardial ablation - box lesion with Cobra Adhere XL®
116(9)
Technical background of Cobra Adhere XL®
117(1)
Heat sink effect
118(1)
Practical use of Cobra Adhere XL®
119(2)
7.2 Management of the left atrial appendage
121(4)
7.3 Tricuspid valve repair
125(3)
7.3.1 Access to the tricuspid valve
126(2)
7.3.2 Repair technique
128(1)
7.4 Closure of the ASD
128(3)
7.4.1 Technical considerations
129(1)
7.4.2 Closure of the ASD
129(2)
7.5 Excision of left atrial tumors
131(2)
7.5.1 Theoretical remarks
131(1)
7.5.2 Practical performing
132(1)
Index 133
Ralf Krakor, Klinikum Dortmund, Germany.
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