Letter to the Editor
A selection of cases of direct cannulation in surgery for type A dissection We would like to thank Sami and colleagues for their comments on our manuscript. We also used carbon dioxide field flooding in all cases, for cerebral embolism prevention. We did not reduce the blood pressure by fibrillation...
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| Format: | Text |
| Language: | English |
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| Online Access: | http://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.1000.4355 http://aan.sagepub.com/content/22/7/888.full.pdf |
| Summary: | A selection of cases of direct cannulation in surgery for type A dissection We would like to thank Sami and colleagues for their comments on our manuscript. We also used carbon dioxide field flooding in all cases, for cerebral embolism prevention. We did not reduce the blood pressure by fibrillation because it decreases to 30–40mm Hg in less than 10 seconds, and does not need extra measures. Further, when the blood pressure reduces, the true lumen can be picked up easily. We do not ventilate the patients with 100 % oxygen before draining the blood from the heart, nor place ice bags around the patient’s head. We infrequently experienced an exces-sive leak around the cannula. In many cases, by pinch-ing with our fingers, we could assess the condition of the aortic wall and avoid heavily diseased areas. In our institution, cardiopulmonary bypass is started when the rectal temperature reaches 30C, which takes 10–20min. During this time, we tape the neck arteries and establish myocardial protection. Generally, we use a minimum length of incision. In addition, because of the institution of antegrade blood flow, retrograde flow is inhibited. Funding |
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