title: Retrospective Cohort Study Comparing Redo Operations Using Ferromagnetic Dissection and Conventional Monopolar Dissection.
abstract: Purpose To evaluate effectiveness of a novel hemostatic dissection tool in patients with congenital heart disease undergoing redo pericardiac dissections. Description This dissection tool employs ferromagnetic energy to cut and coagulate. The unit passes no electric current through the patient, thus eliminating cautery-induced dysrhythmias and electrical interference. Ferromagnetic dissection is precise and reduces thermal injury spread by as much as 90%. Evaluation We case matched 22 patients undergoing reoperation for congenital heart surgery by weight/operation. Group 1 used the ferromagnetic tool, and Group 2 used conventional monopolar cautery for pericardiac dissection. For groups 1 and 2, the mean weight was 27.7 and 28.4, respectively (P = .87). Time (minutes) from skin incision to cardiopulmonary bypass was 71 versus 72 (P = .44), cardiopulmonary bypass (minutes) was 75.6 versus 73.6 (P = .42), total operative time (minutes) was 193 versus 201 (P = .34). Chest tube output/kilogram in first 6 and first 24 hours was 0.4 versus 1.3 (P = .02) and 0.8 versus 2.4 (P = .01) for groups 1 and 2, respectively. Re-exploration for bleeding was 0% versus 9% (P = .07). There was no mortality. Conclusion The ferromagnetic dissection system appears safe and efficacious. Bleeding was significantly decreased and the need for re-exploration reduced.
authors.affiliation: CHOC Children's Hospital, Orange, CA, USA starrdoc28@gmail.com.
authors.forename: Joanne P
authors.initials: JP
authors.lastname: Starr
authors.affiliation: CHOC Children's Hospital, Orange, CA, USA.
authors.forename: Richard N
authors.initials: RN
authors.lastname: Gates
authors.affiliation: CHOC Children's Hospital, Orange, CA, USA.
authors.forename: Brian A
authors.initials: BA
authors.lastname: Palafox
authors.affiliation: CHOC Children's Hospital, Orange, CA, USA.
authors.forename: Allison
authors.initials: A
authors.lastname: Quill
mesh_terms: D000328:Adult; D001707:Biopsy, Needle; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D015331:Cohort Studies; D004210:Dissection / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007150:Immunohistochemistry; D059346:Magnets; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D061214:Patient Safety; D012086:Reoperation / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies
keywords: Congenital heart surgery; Ferromagnetic dissection; Monopolar electrocautery