title: [Repeat open heart surgery in a case associated with persistent left superior vena cava: a method of simple occlusion of L-SVC using an alternative extra-pericardial approach and retrograde cardioplegia].
abstract: Twelve years ago, we reported a method of extrapericardial approach to the L-SVC. Since then we have used this approach and performed simple occlusion of L-SVC during cardiopulmonary bypass without any cerebral complications. We have been expecting for a long time and have believed that this method will be very valuable especially in repeat open heart surgery. A case of 49-year-old man successfully underwent a redo operation for mitral and tricuspid valve replacement using extrapericardial occlusion of the L-SVC and retrograde cardioplegia. Although there was a pitfall for retrograde cardioplegia in the persistent L-SVC and a possibility of steal of cardioplegic fluid through a branch of the accessory hemiazygos vein during retrograde cardioplegia for a case with persistent L-SVC, sufficient cardiac protection was obtained in the case presented.
authors.affiliation: Department of Cardiovascular Surgery, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Oosawa
authors.forename: A
authors.initials: A
authors.lastname: Sakai
authors.forename: M
authors.initials: M
authors.lastname: Abe
authors.forename: N
authors.initials: N
authors.lastname: Hanayama
authors.forename: Z B
authors.initials: ZB
authors.lastname: Lin
authors.forename: K
authors.initials: K
authors.lastname: Kodera
mesh_terms: D001021:Aortic Valve / Q000601:surgery; D006348:Cardiac Surgical Procedures / Q000379:methods; D006324:Heart Arrest, Induced / Q000379:methods*; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D012086:Reoperation; D014683:Vena Cava, Superior / Q000002:abnormalities* / Q000601:surgery*