Operativk procedures on the heart or major intra thoracic vessels done when the heart is beating and supporting effective circulation come under the categoiy of closed heart surgery.
Techniques
Depending on the type of surgery planned, the heart may be approached through median sternotomy, left or right thoracotomy. The problems encountered could be due to haemomhage, hypotension, cardiac arrhythmias including ventricular fibrillation and cardiac arrest. In cases where such complications are anticipated,cardio pulmonary by pass pump is kept standby and the procedure could be converted to an open one, if needed.
Applications
The first operation conducted was ligation of a patent ductus arteriosus through a left thoracotomy. Same approach is used for repair of coarctation of the aorta, a few of the interrupted aortic arches; pulmonary artery banding and palliative aorto pulmonary shunts. Blalock-Taussig shunt (BT shunt), (either classical or modified). Potts shunt between left pulmonary artery and descending thoracic aorta are also done through left thoracotomy. This is also the approach for closed mitral .valvotomy (CMV). Right thoracotomy is used for classic or modified ,Blalock-Taussig shunt. Waterston shunt between pulmonary artery and posterior aspect of ascending aorta and Blalock-Hanlon atrial septectomy are done through this approach.
Partial pe'nicardiectomy can be done through a left thoracotomy or a median sternotomy. Central aorto pulmonary shunts with Goretex grafts, pulmonary artery banding, closed pulmonary valvotomy and infundibular resection can be done through a median sternotomy approach.The latest addition to the list of closed heart surgery is coronary irtery by pass
Techniques
Depending on the type of surgery planned, the heart may be approached through median sternotomy, left or right thoracotomy. The problems encountered could be due to haemomhage, hypotension, cardiac arrhythmias including ventricular fibrillation and cardiac arrest. In cases where such complications are anticipated,cardio pulmonary by pass pump is kept standby and the procedure could be converted to an open one, if needed.
Applications
The first operation conducted was ligation of a patent ductus arteriosus through a left thoracotomy. Same approach is used for repair of coarctation of the aorta, a few of the interrupted aortic arches; pulmonary artery banding and palliative aorto pulmonary shunts. Blalock-Taussig shunt (BT shunt), (either classical or modified). Potts shunt between left pulmonary artery and descending thoracic aorta are also done through left thoracotomy. This is also the approach for closed mitral .valvotomy (CMV). Right thoracotomy is used for classic or modified ,Blalock-Taussig shunt. Waterston shunt between pulmonary artery and posterior aspect of ascending aorta and Blalock-Hanlon atrial septectomy are done through this approach.
Partial pe'nicardiectomy can be done through a left thoracotomy or a median sternotomy. Central aorto pulmonary shunts with Goretex grafts, pulmonary artery banding, closed pulmonary valvotomy and infundibular resection can be done through a median sternotomy approach.The latest addition to the list of closed heart surgery is coronary irtery by pass
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