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
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