BookJohn A. Elefteriades, Bulat A. Ziganshin.
Summary: This textbook provides practical tips on the conduct of aortic surgery, from the aortic valve to the iliac arteries. It is organized as a series of Plates, each with a key central illustration, followed by bullet items of accompanying explanatory text. The accompanying text concentrates on specific, critical dos and donts that promote and enhance patient safety. Chapters include dozens of color illustrations by one of the nations premier medical illustrators, along with selected classic pen and ink line drawings. Each central illustration is accompanied by additional secondary figures interspersed at intervals within the accompanying text. Each practical tip has an accompanying short (15-30 second) video demonstrating vividly the specific didactic point being made in each Plate. Chapters provide Q & A sections, to promote an interactive feel and experience. The textbook shares practical, potentially life-saving tipsgleaned from over three decades of experience in thousands of aortic operationsregarding virtually every standard operation that arises in aortic surgery. Practical Tips in Aortic Surgery will be an essential resource for surgeons and trainees at all levels of experience: residents and fellows, surgical physician assistants, surgical nurses and technicians, and medical students. The book directly targets two surgical specialties: Cardiac Surgery and Vascular Surgery.
Contents:
Section 1. General Tips
General Approach
Cannulation Sites
Bevel Your Distal Ascending or Hemi-Arch Anastomosis
Aortic Wrap
Carbon Dioxide Flooding of the Pericardial Well
Innominate Vein Ligation
Pericardial Bridge for Delayed Sternal Closure
Pull Hard on Graft to Measure Length
Reduction of Graft Diameter
Increase of Graft Diameter
Reinforcement of Posterior Wall of Aortic Anastomosis
Retrosternal Sponge Re-entry Technique
Reinforced Sternal Closure
The Tightening Stitch
Towel Clip Technique to Control Re-entry Bleeding
Turn Off LV Vent Well Before Finishing Last Ascending Suture Line
Conduct of DHCA
Clamping the Aorta
Other Cerebral Perfusion Strategies
Swing Venous Line Down to Expose Aortic Root
Intraoperative Malperfusion
Surrounding the Ascending AortaWithout Injuring the PA
Do NOT obliterate a chronic flap
Hugging but not Restricting the Innominate Artery with the Clamp
Do Not Cut Too Close to the Clamp
Graft Sizing
Valerie Stitch for Exposure of the Aortic Root
Cannulation of Left Inferior Pulmonary Vein
Left Atrial Cannulation in Atrial Fibrillation
The E-Rule: Never Start LA-FA Artery Perfusion w/o the Aorta Clamped
Remember the Pulmonary Artery for Venous Return
Mobilize the Posterior Wall Completely
Mobilize the Descending Aorta from the Esophagus
Sub-adventitial Hematoma
Sienna graft for Mega-aorta
The Inclusion Anastomotic Technique
Big Needle for Thick Aortas
Aneurysms of the Branches of the Aortic Arch
Attaching Arch Graft to Ascending Graft (Configurations)
BioGlue on Graft-to-Graft Anastomoses
Lung Adhesions
Adherence of Aneurysm to Chest Wall
Reoperative Adhesions
Extracting old prosthetic valves
Section 2. Ascending Aorta and Aortic Arch
Aortic Morphology Determines Extent of Resection
Use the Corner of the Commissure to Advantage
Aortic Valve Repair
Ascending Aortic Replacement (*deeper stitches on non-coronary sinus)
Composite Graft (Aortic Root Replacement) (Bentall Procedure)
Composite Graft (Aortic Root Replacement) (Bentall Procedure)
V-Shaped Aortic Root Remodeling
Valve-Sparing Aortic Root Replacement
Arch Replacement Options (2-vessel, 3-vessel, trifurcated graft)
Standard (Non-Frozen) Elephant Trunk Procedure
Retrieving the Elephant TrunkFour Options
Stand-alone Elephant Trunk
Acute Type A Aortic Dissection
Ross Procedure
Section 3. Descending and Thoracoabdominal Aorta
Descending Aortic Replacement
Acute Type B Aortic Dissection: Clinical Perspectives to Guide Surgery
Fenestration Procedure
Thoracoabdominal Aortic Replacement
Abdominal aortic replacement
Visceral artery aneurysms
Pulmonary Artery Aneurysms
Section 4. Vascular Rings
General Comments
Vascular Rings and Kommerils Diverticula.