Vo Thin Xuan, Boodhwani Munir
Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Multimed Man Cardiothorac Surg. 2021 May 10;2021. doi: 10.1510/mmcts.2021.030.
Peripheral vascular access and closure are fundamental skills in cardiovascular surgery, especially in the era of transcatheter and minimally invasive surgical techniques. Conventional arterial access via surgical cutdown typically requires vascular clamps for surgical control and primary closure. We have been utilizing a surgical preclosure technique that does not require vascular clamping. The technique utilizes 4 to 5 full-thickness Prolene sutures placed in an interrupted fashion at the site of access instead of traditional purse-string sutures. These sutures are placed prior to vascular access. The sutures are not tied down until the procedure is complete and the vascular sheath is removed. This technique allows for adequate control and closure of the peripheral access artery without the use of vascular clamps and avoids traumatic manipulation of the artery.
外周血管穿刺和闭合是心血管外科的基本技能，尤其是在经导管和微创手术技术的时代。传统的通过手术切开进行动脉穿刺通常需要血管夹来进行手术控制和一期闭合。我们一直在使用一种无需血管夹的手术预闭合技术。该技术在穿刺部位以间断方式放置4至5根全层普理灵缝线，而不是传统的荷包缝线。这些缝线在进行血管穿刺之前放置。直到手术完成并拔除血管鞘后才结扎这些缝线。该技术无需使用血管夹即可充分控制和闭合外周穿刺动脉，避免了对动脉的创伤性操作。
