Lung exposure during simultaneous myocardial revascularization and lung surgery through median sternotomy
نویسندگان
چکیده
Coronary artery disease is a frequent comorbidity in patients undergoing major thoracic surgery. Simultaneous operations eliminate the necessity of a second operation and, more importantly, minimize the delay in compulsory postoperative oncological therapy. We describe a relaxing incision in the contralateral pericardium, which allows for simple displacement of the heart. This maneuver improves exposure of the pulmonary hilum and middle mediastinum on the side of resection.
منابع مشابه
Combined median sternotomy and video-assisted thoracoscopic resection of pulmonary metastases.
Median sternotomy has been a common approach for resection of bilateral pulmonary metastases. It provides good exposure and quick accessibility to most lesions in the lung. The retrocardiac left lower lobe may at times be a problematic area for resection of metastases. We have used a simultaneous median sternotomy and left video-assisted thoracoscopic approach to remove three such lesions in tw...
متن کاملA rigid barrier between the heart and sternum protects the heart and lungs against rupture during negative pressure wound therapy
OBJECTIVES Right ventricular heart rupture is a devastating complication associated with negative pressure wound therapy (NPWT) in cardiac surgery. The use of a rigid barrier has been suggested to offer protection against this lethal complication, by preventing the heart from being drawn up and damaged by the sharp edges of the sternum. The aim of the present study was to investigate whether a ...
متن کاملSternothoracotomy for combined coronary artery bypass grafting and left upper lobectomy in a patient with low-lying tracheostoma.
A 64-year-old man had a low-lying tracheostoma and presented with unstable angina and a mass in the pulmonary left upper lobe. Simultaneous coronary revascularization and resection of the lung neoplasm were completed through a sternothoracotomy (clam-shell) incision. The advantages of this approach include excellent exposure to the mediastinum and the lung fields, and the option of using both i...
متن کاملEvaluation of Aortic Valve Replacement via the Right Parasternal Approach without Rib Removal.
BACKGROUND Although right parasternal approach (RPA) decreases the incidence of mediastinal infection, this approach is associated with lung hernia and flail chest. Our RPA employs thoracotomy with bending rib cartilages and wound closure performed by repositioning the ribs with underlying sheet reinforcement. METHODS We evaluated 16 patients who underwent aortic valve replacement via the RPA...
متن کاملCardiac gene delivery with cardiopulmonary bypass.
BACKGROUND Cardiac gene therapy offers the possibility of enhancing myocardial performance in the compromised heart. However, current gene delivery techniques have limited myocardial transgene expression and pose the risk of extracardiac expression. Isolation of the coronary circulation during cardiac surgery may allow for more efficient and cardiac-selective gene delivery in a clinically relev...
متن کامل