[Intraoperative fiber optic angioscopy during cardiovascular surgery].
The usefulness and limitation of intraoperative angioscopy in the field of cardiovascular surgery were investigated based on our clinical experience. Considerable leakage of cardioplegic solution through the aortic valve due to valve regurgitation was angioscopically demonstrated when the infusion pressure in the aortic root was less than 10 mmHg. This indicates that the cardioplegia must be infused with an aortic pressure of above 20 mmHg for appropriate myocardial protection. After thromboendarterectomy on the arteriosclerosis obliterans, fixation with the edge of the residual intimal flap to the arterial wall was performed correctly under direct visualization. The status of thrombus organization in deep vein thrombosis was evaluated. Even after complete thrombectomy, iliac compression was still demonstrated. Blood in the cardiovascular lumen can be easily cleaned by saline flushing. However, careful attention to fluid overloading must be employed when the observation period is prolonged.
Ishimaru
S
S
Department of Surgery, Tokyo Medical College, Japan.
Hakoshima
A
A
Osada
K
K
Hirayama
T
T
Yamaguchi
H
H
Furukawa
K
K
D001021:Aortic Valve / Q000473:pathology; D001022:Aortic Valve Insufficiency / Q000175:diagnosis; D001158:Arteries / Q000473:pathology; D001162:Arteriosclerosis Obliterans / Q000601:surgery; D006348:Cardiac Surgical Procedures / Q000379:methods; D004691:Endarterectomy / Q000379:methods; D004724:Endoscopy / Q000379:methods; D005336:Fiber Optic Technology; D006324:Heart Arrest, Induced / Q000379:methods; D006801:Humans; D007084:Iliac Vein / Q000473:pathology; D007430:Intraoperative Care; D055100:Optical Fibers; D013927:Thrombosis / Q000601:surgery; D014656:Vascular Surgical Procedures / Q000379:methods