title: Could the novel 'double-hole' technique be an alternative for the inflow occlusion method?
abstract: BACKGROUND
  Inflow occlusion on beating heart and cardiopulmonary bypass techniques have been proposed for the removal of foreign material, such as stents, catheters and mass lesions, from cardiac chambers. However, both techniques are not devoid of disadvantages and complications. In this article, we define an alternative, novel 'double-hole' technique, which is based on opening the right atrium without cardiopulmonary bypass.
  
  
  METHODS
  Bovine hearts were obtained from a local supermarket. Two purse-string sutures were placed in the right atrium using 2-0 braided, non-absorbable polyester suture material, one close to the auricle, and the other close to the interatrial septum. The guidewire of a haemodialysis catheter was inserted through the superior vena cava into the right atrium and passed all the way through the right ventricle.
  
  
  RESULTS
  We suggest that the double-hole technique may be useful, especially in revision cases with adhesions. Further research should be performed to document the efficacy and safety of this method.
  
  
  CONCLUSIONS
  We are aware that further extensive research is necessary to investigate the utility of this novel technique in contemporary cardiovascular surgery. We believe the doublehole technique has the potential to become a safe, practical and effective measure in the future.
authors.affiliation: Department of Cardiovascular Surgery, Faculty of Medicine, Recep Tayyip Erdogan University, Training and Research Hospital, Rize, Turkey. Email: sahinboz@yahoo.com.
authors.forename: Sahin
authors.initials: S
authors.lastname: Bozok
authors.affiliation: Department of Cardiovascular Surgery, Faculty of Medicine, Recep Tayyip Erdogan University, Training and Research Hospital, Rize, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Ilhan
authors.affiliation: Department of Anesthesiology and Reanimation, Faculty of Medicine, Recep Tayyip Erdogan University, Training and Research Hospital, Rize, Turkey.
authors.forename: Hizir
authors.initials: H
authors.lastname: Kazdal
authors.affiliation: Department of Cardiovascular Surgery, Faculty of Medicine, Izmir Katip Celebi University, Atatürk Training and Research Hospital, Izmir, Turkey.
authors.forename: Berkan
authors.initials: B
authors.lastname: Ozpak
authors.affiliation: Department of Cardiovascular Surgery, Faculty of Medicine, Izmir Katip Celebi University, Atatürk Training and Research Hospital, Izmir, Turkey.
authors.forename: Ismail
authors.initials: I
authors.lastname: Yurekli
authors.affiliation: Institute of Oncology, Dokuz Eylul University, Izmir, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Bayrak
authors.affiliation: Department of Cardiovascular Surgery, Faculty of Medicine, Izmir Katip Celebi University, Atatürk Training and Research Hospital, Izmir, Turkey.
authors.forename: Mert
authors.initials: M
authors.lastname: Kestelli
mesh_terms: D000818:Animals; D006328:Cardiac Catheterization; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002417:Cattle; D020878:Device Removal / Q000379:methods*; D005547:Foreign Bodies / Q000601:surgery*; D006325:Heart Atria / Q000601:surgery*; D023421:Models, Animal; D013536:Suture Techniques