Nishimura Y, Okamura Y, Fujiwara K, Sekii H, Yamamoto S, Tonda H, Toguchi K
Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University, Wakayama, Japan.
Kyobu Geka. 2003 Jul;56(8 Suppl):630-4.
Heart displacement during off-pump coronary artery bypass grafting (OPCAB) is necessary to expose the anastomotic site. However, such displacement causes hemodynamic deterioration especially in the exposure of the circumflex branches and posterior descending artery (PDA). In this study we present two different cardiac positioning for the exposure of the anastomotic site of PDA. To expose the mid-portion of PDA the heart is vertically displaced by fixing the suction cup of the heart positioner on apex. To expose the proximal portion of PDA the suction cup is attached on the acute margin of the right ventricle (off apex). By using these 2 different techniques properly, hemodynamic deterioration can be avoided during OPCAB for PDA.
非体外循环冠状动脉旁路移植术(OPCAB)期间进行心脏移位对于暴露吻合部位是必要的。然而,这种移位会导致血流动力学恶化,尤其是在暴露回旋支和后降支动脉(PDA)时。在本研究中,我们提出了两种不同的心脏定位方法用于暴露PDA的吻合部位。为了暴露PDA的中部,通过将心脏定位器的吸盘固定在心脏尖部使心脏垂直移位。为了暴露PDA的近端,将吸盘附着在右心室的锐缘(非心脏尖部)。通过正确使用这两种不同技术,可以在PDA的OPCAB期间避免血流动力学恶化。