Root-commando operation for multivalvular endocarditis and pericardiectomy
| Autor: | Irene Rovira, Elena Sandoval, Eduard Quintana, María Ascaso, Alejandro Fernández-Cisneros |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Constrictive pericarditis
medicine.medical_specialty business.industry medicine.medical_treatment medicine.disease law.invention Surgery Bicuspid aortic valve law medicine.artery Ascending aorta cardiovascular system medicine Cardiopulmonary bypass Endocarditis Commando operation Pericardiectomy Abscess business |
| Zdroj: | The Multimedia Manual of Cardio-Thoracic Surgery. |
| Popis: | This video tutorial presents the reconstruction of the intervalvular fibrosa and a triple valve replacement, due to prosthetic valve endocarditis, in a patient with previous chest irradiation and bicuspid aortic valve replacement. Constrictive pericarditis was also present since the original operation. A detailed step-by-step demonstration of the reconstruction of the intervalvular fibrosa and debridement of extensive prosthetic valve endocarditis with paravalvular root abscess are provided. A secondary sternotomy was performed and, in the process, the ascending aorta was injured, with associated life-threatening bleeding. Manual compression was applied while peripheral cannulation and cardiopulmonary bypass were started. The bleeding was controlled with cooling and circulatory arrest and the ascending aorta was replaced with a Dacron graft. The intervalvular fibrosa was reconstructed using a folded pericardial patch. Aortic root replacement with a cryopreserved homograft was performed and the mitral and tricuspid valves were replaced with tissue valve prostheses. A complete pericardiectomy was performed. The chest was left packed with cotton due to diffuse bleeding. At the time of the delayed chest closure, a permanent epicardial pacemaker was implanted. |
| Databáze: | OpenAIRE |
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