Esternotomia mediana como via preferencial na anastomose de Blalock-Taussig modificada
Autor: | Flávio P Oliveira, Paulo R. Prates, Orlando Carlos Belmonte Wender, Sharbel M Boustany, Renato A. K. Kalil, João Ricardo M. Sant'Anna, Guaracy F Teixeira Filho, Ivo A. Nesralla, Rogério Abrahão |
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Jazyk: | portugalština |
Rok vydání: | 1997 |
Předmět: |
medicine.medical_specialty
Anastomose cirúrgica lcsh:Diseases of the circulatory (Cardiovascular) system Anastomosis medicine.medical_treatment lcsh:Surgery Anastomose cirúrgica/métodos Pulmonary atresia Estenose da valva pulmonar Tricuspid atresia medicine Estenose da valva pulmonar/cirurgia Pulmonary atresia/surgery Thoracotomy Double outlet right ventricle Tricuspid atresia/surgery Atresia tricúspide Lung Atresia pulmonar business.industry Dupla via de saída do ventrículo direito Heart surgery/methods Double outlet right ventricle/surgery General Medicine Left pulmonary artery lcsh:RD1-811 Dupla via de saída do ventrículo direito/cirurgia Right pulmonary artery Anastomosis/surgical methods Surgery Heart surgery medicine.anatomical_structure Median sternotomy lcsh:RC666-701 Cirurgia cardíaca Atresia pulmonar/cirurgia Cirurgia cardíaca/métodos Cardiology and Cardiovascular Medicine business Shunt (electrical) Atresia tricúspide/cirurgia Artery |
Zdroj: | Brazilian Journal of Cardiovascular Surgery v.12 n.2 1997 Brazilian Journal of Cardiovascular Surgery Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV) instacron:SBCCV Brazilian Journal of Cardiovascular Surgery, Vol 12, Iss 2, Pp 166-168 (1997) Brazilian Journal of Cardiovascular Surgery, Volume: 12, Issue: 2, Pages: 166-168, Published: APR 1997 |
Popis: | A abordagem usual para a realização da anastomose de Blalock-Taussig modificada (ABTM) tem sido a toracotomia lateral. Esta via acarreta necessariamente trauma ao parênquima pulmonar e acesso difícil por ocasião da operação definitiva. A esternotomia mediana (EM) apresenta-se como uma alternativa com certas vantagens. Este trabalho visa avaliar a viabilidade técnica e os resultados da realização da ABTM por EM. Dez pacientes foram submetidos a esta técnica, interpondo-se enxertos de PTFE. A mortalidade imediata foi de 30%, e a tardia de 10%. Complicação imediata ocorreu em 10%. O tempo médio de internação foi 7,0 ± 0,5 dias. A variação da saturação da hemoglobina pré e pós-operatória foi 27,5 ± 11,7% (pThe usual approach for systemic-pulmonary shunts has been right or left thoracotomy and interposition of a PTFE vascular graft between the subclavian and pulmonary arteries. This approach, necessarily causes, trauma to the lungs and some difficulty for dissection and ligation later during definitive surgical correction. Median sternotomy has been used occasionally for right subclavian-pulmonary artery anastomosis with certain advantages over thoracotomy. In this series, 10 patients were submitted to systemic-pulmonary modified Blalock-Taussig shunts by median sternotomy as the first choice. There have been no technical difficulties. The grafts were anastomosed to the right subclavian artery or brachiocephalic trunk. The right pulmonary artery was preferred, but when infeasible, this side of the shunt was made to the pulmonary trunk or left pulmonary artery. There have been 3 early and 1 late death, unrelated to the shunt. Arterial saturation improved by 27.5 ± 11.7% (p |
Databáze: | OpenAIRE |
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