By Richard A. Jonas
This ebook is the 1st unmarried authored textbook masking the total spectrum of surgical administration of congenital middle ailment. the writer, Dr. Richard Jonas, is the executive of Cardiovascular surgical procedure at Children's health facility Boston and the fourth William E Ladd Professor of surgical procedure at Harvard scientific tuition. administration of congenital center disorder at the present time calls for a collaborative attempt by means of a wide healthcare group together with congenital cardiac surgeons but in addition pediatric cardiologists, pediatric cardiac intensivists, pediatric cardiac anesthesiologists, perfusion and respiration technicians and pediatric nurses. All of those members should have a transparent realizing of the surgical manipulations that happen within the working room. This textbook offers superbly illustrations that basically depict even the main complicated strategies. yet this publication is far greater than an operative atlas. It offers evidence-based medication that gives quite a few medical citations which clarify not just how an operation may be performed but also whilst and why it's going to be performed and the results of those interventions.
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Additional info for Comprehensive Surgical Management of Congenital Heart Disease (Hodder Arnold Publication)
There is a real risk that air will be entrained into the left heart through the incision in the left atrium or through the vent cannula as it is introduced. It is safer to wait until either the heart has ﬁbrillated or the cross clamp has been applied. However distention may occur before the heart has ﬁbrillated. The surgeon needs to watch the main pulmonary artery as the best guide to left heart distention because it is usually difﬁcult to see the degree of left ventricular distention directly and it is usually not possible in young patients to insert a Swan–Ganz catheter.
7). These are important potential sites of bleeding. If it will be very difﬁcult to reaccess these sites, such as the coronary button anastomoses in the arterial switch procedure, it is wise to reinforce them before moving on. 7 The point of transition between an everting and inverting suture line is an important potential site for bleeding. Points of transition should be reinforced with additional interrupted sutures if they are not likely to be readily accessible later in the procedure. surgeon should make a mental note as to where these sites are throughout the reconstruction and return to them ﬁrst if bleeding is a problem.
A patent aortopulmonary shunt also increases left heart return. Aortopulmonary window, truncus arteriosus and anomalous coronary artery from the pulmonary artery are other anomalies where the surgeon must carefully guard against left heart distention. Finally aortic regurgitation is a unique cause of left heart distention in that it is upstream to a competent valve (mitral) from the left atrium. Thus the method for venting must be to drain the left ventricle itself while all the other causes can be dealt with by left atrial or pulmonary artery venting.
Comprehensive Surgical Management of Congenital Heart Disease (Hodder Arnold Publication) by Richard A. Jonas