Department of Surgery, Section of Cardiothoracic Surgery, University of Nebraska Medical Center, Children's Hospital and Medical Center, Omaha, Nebraska 68195, USA.
Ann Thorac Surg. 2012 Sep;94(3):1021-2. doi: 10.1016/j.athoracsur.2012.04.125.
Deep hypothermic circulatory arrest or low-flow bypass are commonly used in primary repair of total anomalous pulmonary venous connection, or individual veins may be dissected to allow clamp or snare application, in order to provide a bloodless field for anastomosis by the direct or sutureless marsupialization technique. In the described technical modification, the marsupialization of the opened atrium to the posterior pericardium is completed before opening the pulmonary venous confluence, allowing bloodless exposure during full-flow normothermic bypass. In addition, vein branch dissection is avoided.
深低温停循环或低流量旁路通常用于完全性肺静脉异常连接的一期修复，或者可以解剖各个静脉，以便通过直接或无缝线的开窗技术进行吻合时，为吻合口提供无血视野。在描述的技术改良中，在打开肺静脉汇流之前完成将打开的心房向心包后外侧的开窗，从而在全流量常温旁路期间实现无血显露。此外，避免了静脉分支的解剖。
