反向瓣膜Potts分流术治疗难治性原发性肺动脉高压。

Q4 Medicine Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Pub Date : 2025-01-16 DOI:10.1510/mmcts.2024.120

Sebastian Michel, Joseph Pattathu, Jürgen Hörer, Fabian A Kari

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引用次数: 0

摘要

该手术通过标准主动脉和双颅插管进行全胸骨切开术。对于主动脉和肺动脉吻合口，在体温降至26℃后，采用选择性顺行单侧脑灌注。在肺动脉和近端降主动脉之间置入12mm汉考克导管，采用标准运行缝合技术。在具有挑战性的术后管理过程中，关键的决策包括但不限于，在全体性缺氧的情况下，使用静脉静脉体外膜氧合作为间歇性支持，以及抗凝和抗血小板方案，以提供间歇性打开的汉考克瓣膜的最佳长期功能。

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Reversed valved Potts shunt for refractory primary pulmonary arterial hypertension.

This procedure is carried out via a full sternotomy using standard aortic and bicaval cannulations. For the aortic and pulmonary anastomoses, selective antegrade unilateral cerebral perfusion is used after cooling the body temperature to 26 °Celsius. A 12-mm Hancock conduit is interposed between the pulmonary artery and the proximal descending aorta using standard running suture techniques. Critical decisions during the challenging postoperative management include, but are not limited to, the use of venovenous extracorporeal membrane oxygenation for intermittent support in case of systemic deoxygenation and the anticoagulation and antiplatelet regimen to provide optimal long-term function of the intermittently opening Hancock valve.

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来源期刊

Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery Medicine-Medicine (all)

CiteScore

0.60

自引率

0.00%

发文量

期刊介绍： The Multimedia Manual of Cardio-Thoracic Surgery (MMCTS) is produced by The European Association for Cardio-Thoracic Surgery (EACTS). MMCTS is the world’s premier video-based educational resource for cardiovascular and thoracic surgeons; freely accessible - and essential - for all. MMCTS was launched more than ten years ago under the leadership of founding editor Professor Marko Turina. It was Professor Turina’s vision that the European Association for Cardio-Thoracic Surgery (EACTS), already the world-leader in CT surgery education, should take advantage of the Internet’s rapidly improving video publication capabilities and create a new step-by-step manual of surgical procedures. Professor Turina and EACTS agreed that the manual, MMCTS, should be freely accessible to all users, regardless of association membership status, nationality, or affiliation. MMCTS was self-published by EACTS for some years before being transferred to Oxford University Press, which hosted it until the end of 2016. In November 2016, the Manual returned home to EACTS and it has now relaunched in a completely new format. Since its birth in 2005, MMCTS has published some 400 detailed, video-based demonstrations of cardio-thoracic surgical procedures. Tutorials published prior to 2012 have been archived and we are working with the authors of these tutorials to update their work pending republication on the new site. Our mission is to make MMCTS the best online reference for cardio-thoracic surgeons – residents and experienced surgeons alike. Our aim is to include tutorials presenting procedures at both a fundamental and an advanced level. Truly innovative procedures are also included and are identified as such.