A transthoracic, left ventricular vent facilitates challenging sternal reentry.
In this brief report, we describe a technique to facilitate hypothermic arrest before a redo sternotomy that is likely to require extensive dissection. This approach may be well-suited for patients with significant aortic insufficiency, as it allows control of left ventricular distention once hypothermic ventricular fibrillation ensues. The procedure entails inserting a second venous cannula through the left ventricular apex through a 7-cm left mini-thoracotomy. We used the technique successfully in a patient with a ruptured, infected ascending aortic pseudoaneurysm and severe aortic insufficiency who had undergone a previous sternotomy.
Cohn
William E
WE
Center for Cardiac Support, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, TX, USA. wcohn@heart.thi.tmc.edu
D017541:Aneurysm, False / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001019:Aortic Rupture / Q000601:surgery*; D006328:Cardiac Catheterization; D050792:Circulatory Arrest, Deep Hypothermia Induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D013249:Sternum / Q000601:surgery*