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Minimal invasive coronary artery fistula ligation.

Mitropoulos FA, Kanakis MA, Chatzis A, Contrafouris C, Sofianidou IA, Lioulias AG - Korean J Thorac Cardiovasc Surg (2014)

Bottom Line: A coronary artery fistula was surgically ligated in a 38-year-old woman via a left anterior mini-thoracotomy without the use of cardiopulmonary bypass.In selected cases, this surgical approach can provide an excellent surgical exposure for coronary artery fistula ligation.It also offers an excellent cosmetic result and shorter hospital stay.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Center.

ABSTRACT
A coronary artery fistula was surgically ligated in a 38-year-old woman via a left anterior mini-thoracotomy without the use of cardiopulmonary bypass. In selected cases, this surgical approach can provide an excellent surgical exposure for coronary artery fistula ligation. It also offers an excellent cosmetic result and shorter hospital stay.

No MeSH data available.


Related in: MedlinePlus

Intraoperative photo showing (A) the fistulous tract (arrows) and (B) multiple pledgeted 5-0 polypropylene sutures occluding the fistula on the pulmonary artery side (arrows).
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f2-kjtcvs-47-545: Intraoperative photo showing (A) the fistulous tract (arrows) and (B) multiple pledgeted 5-0 polypropylene sutures occluding the fistula on the pulmonary artery side (arrows).

Mentions: A left anterior mini-thoracotomy (5 cm) was performed and the thoracic cavity was entered via the third intercostal space. With the left lung deflated, the left phrenic nerve was identified; the pericardium was then incised and suspended to the margins of the incision. The exposure was excellent and the fistulous tracts were identified (Fig. 2A). The fistula on the pulmonary artery side was obliterated with multiple pledgeted 5-0 polypropylene sutures (Fig. 2B). Transesophageal echocardiography confirmed the successful closure of the fistula, the lack of a residual shunt, and the lack of wall motion abnormalities, while the electrocardiogram did not show any signs of ischemia. The patient was extubated one hour after the completion of the procedure in the intensive care unit and was then transferred to the general ward. She was discharged on the second postoperative day. At six and twelve months follow-up, she remained free of any cardiovascular symptoms, while echocardiography showed no residual flow. Moreover, an excellent cosmetic result was achieved.


Minimal invasive coronary artery fistula ligation.

Mitropoulos FA, Kanakis MA, Chatzis A, Contrafouris C, Sofianidou IA, Lioulias AG - Korean J Thorac Cardiovasc Surg (2014)

Intraoperative photo showing (A) the fistulous tract (arrows) and (B) multiple pledgeted 5-0 polypropylene sutures occluding the fistula on the pulmonary artery side (arrows).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4279827&req=5

f2-kjtcvs-47-545: Intraoperative photo showing (A) the fistulous tract (arrows) and (B) multiple pledgeted 5-0 polypropylene sutures occluding the fistula on the pulmonary artery side (arrows).
Mentions: A left anterior mini-thoracotomy (5 cm) was performed and the thoracic cavity was entered via the third intercostal space. With the left lung deflated, the left phrenic nerve was identified; the pericardium was then incised and suspended to the margins of the incision. The exposure was excellent and the fistulous tracts were identified (Fig. 2A). The fistula on the pulmonary artery side was obliterated with multiple pledgeted 5-0 polypropylene sutures (Fig. 2B). Transesophageal echocardiography confirmed the successful closure of the fistula, the lack of a residual shunt, and the lack of wall motion abnormalities, while the electrocardiogram did not show any signs of ischemia. The patient was extubated one hour after the completion of the procedure in the intensive care unit and was then transferred to the general ward. She was discharged on the second postoperative day. At six and twelve months follow-up, she remained free of any cardiovascular symptoms, while echocardiography showed no residual flow. Moreover, an excellent cosmetic result was achieved.

Bottom Line: A coronary artery fistula was surgically ligated in a 38-year-old woman via a left anterior mini-thoracotomy without the use of cardiopulmonary bypass.In selected cases, this surgical approach can provide an excellent surgical exposure for coronary artery fistula ligation.It also offers an excellent cosmetic result and shorter hospital stay.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Center.

ABSTRACT
A coronary artery fistula was surgically ligated in a 38-year-old woman via a left anterior mini-thoracotomy without the use of cardiopulmonary bypass. In selected cases, this surgical approach can provide an excellent surgical exposure for coronary artery fistula ligation. It also offers an excellent cosmetic result and shorter hospital stay.

No MeSH data available.


Related in: MedlinePlus