1 / 12

Off Pump and On Pump Coronary Anastomosis Technical Considerations

Off Pump and On Pump Coronary Anastomosis Technical Considerations. technically coronary anastomoses are the same whether it’s on or off pump the same Do’s and Dont’s apply. deep pericardial sutures lift and rotate anterior wall into the operative field

dareh
Download Presentation

Off Pump and On Pump Coronary Anastomosis Technical Considerations

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Off Pump and On PumpCoronary AnastomosisTechnical Considerations

  2. technically coronary anastomoses are the same whether it’s on or off pump the same Do’s and Dont’s apply

  3. deep pericardial sutures • lift and rotate anterior wall into the operative field • aids ‘verticalisation’ (for access to the posterior and inferior circulation)

  4. stabilisation suction Octopus 2 plus LP

  5. “secondary” stabilisation Starfish 2 heart positioner

  6. Starfish 2 Octopus 4 stabiliser heart positioners Urchin

  7. CO2 mist blower • clears “bloody” field • intracoronary shunts • ‘bloodless’ field

  8. intracoronary shunts • ‘bloodless’ field • continued distal perfusion (“myocardial protection”) • crucial for RCA

  9. patient position • trendelenburg with rotation to the right • to reduce haemodynamc impairment(due to right sided compromise) • to improve access and visualisation(to the posterior /inferior circulation)

  10. maintain temperature ~36°C • adequate room temperature • lower body “Bair Hugger”

  11. cell saver • useful but not always required

More Related