[HSF] Rt thoracotomy MVR

[Ani Anyanwu]

Z
 
Thanks a lot for your technical tips and comments. If okay with you I will contact you when I get started and maybe even visit and see how you set these up.
 
Ani
 



> Date: Fri, 11 Apr 2008 16:12:15 -0400> From: zzhoumd at pol.net> Subject: Re: [HSF] Rt thoracotomy MVR> To: OpenHeart-L at lists.hsforum.com> CC: > > Ani,> > In this particular case, I did both mitral valve and tricuspid valve, as > well as right and left atrium ablation. So the incision is larger than the > incision for mitral valve alone. I cannulated the femoral artery and vein. I > also placed a SVC cannulae through the incision as well as a retrograde > line. The SVC and IVC were snared through the incision when I am doing the > tricuspid valve. I still do not have the courage not to snare the cavas.> > Recently, I started using the soft tissue retractor from general surgeons > (we call it "disc"), it can really pull the skin and soft tissue away evenly > in all directions, so a 8cm incision will have the exposure of 12cm incision > without it, (much better than Cardiovasion one and much cheaper). You will > like it once you see it.> > When I do mitral valve alone, the incision is about 5-6 cm, but I use a > thoracoscopy to help visulization. I will attach a picture to show how that > works. You can appreciate the size of the mitral valve on the screen. (this > patient has endocarditis, so I replaced the valve.)> > Hope that helps. Anything good in Boston?> > Zhandong Zhou> > > > ----- Original Message ----- > From: "Ani Anyanwu" <anianyanwu at hotmail.com>> To: <openheart-l at lists.hsforum.com>> Sent: Friday, April 11, 2008 10:14 AM> Subject: RE: [HSF] Rt thoracotomy MVR> > > Dr Zhou> > Thanks for posting picture - excellent exposure and repair - always good to > see a real life image rather than hear the theory. I intend to do more of > these myself.> > Reassuring to me to note though that this incision is probably up to 10cm or > more in length (jugding from the length of the ring and cardiotomy sucker > and that the exposure takes a square shape which will become linear, and > longer, on retractor removal) and that ribs have been spread substantially. > In prior posts it has been said that this surgery is easily done through a > 5cm incision. I had my doubts as to how I personally could effect a repair > through such an incision under direct vision.> > Having seen a few of these 'mini-mitrals' come for reoperations, I often > note a perception gap between what the surgeon feels is the length of his > incision and the reality when you measure it (most surgeons grossly > underestimate) - there are I suspect very few mitrals that are truly done > via 5cm incisions without rib-spreading, as some may claim, unless robotic > or videoscopic approaches are used.> > Ani> > > > > > > From: zzhoumd at pol.net> To: OpenHeart-L at lists.hsforum.com> Subject: Re: > > [HSF] Rt thoracotomy MVR> Date: Wed, 9 Apr 2008 16:21:57 -0400> CC: > > We > > had a good discussion about right thoracotomy approach. I attached a > > picture of right thoracotomy mitral valve repair. This is the case I did > > recently with ablation and closure of appendage.> > Z Zhou> _________________________________________________________________> Get Hotmail on your mobile. Text MSN to 63463 now!> http://mobile.uk.msn.com/pc/mail.aspx_______________________________________________> OpenHeart-L mailing list> > Send postings to:> OpenHeart-L at lists.hsforum.com> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:> http://mmp.cjp.com/mailman/listinfo/openheart-l> > All messages transmitted by the OpenHeart-L are subject to the policies and> disclaimers posted at:> http://www.hsforum.com/listdisclaim> ----------------------------------------- 
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