Endo M, Nishida H, Tomizawa Y, Kihara S, Ishida T, Koyanagi H
The Department of Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women's Medical University, Tokyo Japan.
Heart Surg Forum. 1999;2(4):341-4.
The limited exposure typical of new minimally invasive surgical approaches to cardiac surgery makes it difficult to utilize traditional equipment such as temporary pacing electrodes or the placement of drainage tubes into the lateral pleural space. To overcome these difficulties, we have developed specialized drainage tubes just for limited access cardiac surgery.
The first device is a drainage tube with temporary pacing function. It has three fixed electrodes and one free pacing wire incorporated into an elliptical, angled 28 Fr silicone drainage tube. This tube is placed in the space between the heart and the diaphragm. The two fixed electrodes provide epicardial contact for ventricular pacing. The third fixed electrode and one free pacing wire are for the purpose of atrial pacing (Japanese patent #2,701,135). The second device is a Y-shaped drainage tube. Frequently, the pleural space is opened during harvesting of an internal mammary graft and then insertion of a chest tube in the thoracic cavity becomes necessary. We developed a new Y-shaped tube where one segment is placed in the retrosternal space and one segment is placed in the pleural cavity. (Japanese Association of Intellectual Copyright #130,591)
The drainage-pacing device was used in 48 coronary artery bypass grafting (CABG) patients. Drainage function and pacing function were excellent in all patients. The bifurcated drainage device was used in 34 patients achieving effective drainage of both cavities without complication during or after removal.
Due to the limited surgical exposure provided by the newer minimally invasive procedures in cardiac surgery, specialized equipment that can be inserted through small incisions needs to be developed. We report the development of a new drainage-pacing device as well as a bifurcated drain for simultaneous drainage of the mediastinal and pleural cavities. These devices have facilitated minimally invasive cases and were free of complications.
新型微创心脏手术方法的暴露范围有限，这使得使用传统设备（如临时起搏电极或将引流管放置到侧胸膜腔）变得困难。为克服这些困难，我们专门开发了用于有限切口心脏手术的引流管。
第一种设备是具有临时起搏功能的引流管。它有三个固定电极和一根游离起搏线，集成在一根椭圆形、成角的28F硅胶引流管中。该引流管放置在心脏与膈肌之间的间隙。两个固定电极用于心室起搏时的心外膜接触。第三个固定电极和一根游离起搏线用于心房起搏（日本专利#2,701,135）。第二种设备是Y形引流管。在内乳动脉移植物获取过程中，胸膜腔常常会打开，随后就需要在胸腔内插入胸管。我们开发了一种新的Y形管，其中一段放置在胸骨后间隙，另一段放置在胸膜腔内。（日本知识产权协会#130,591）
48例冠状动脉旁路移植术（CABG）患者使用了引流起搏装置。所有患者的引流功能和起搏功能均良好。34例患者使用了分叉引流装置，在拔除过程中及拔除后均有效引流了两个腔隙且无并发症发生。
由于新型微创心脏手术提供的手术暴露范围有限，需要开发能够通过小切口插入的专用设备。我们报告了一种新型引流起搏装置以及用于同时引流纵隔和胸膜腔的分叉引流管的开发情况。这些装置有助于开展微创病例且无并发症。
