Left Ventricular Diverticulum - Pentalogy of Cantrell - Pericardial stays and thymectomy completion скачать в хорошем качестве

Left Ventricular Diverticulum - Pentalogy of Cantrell - Pericardial stays and thymectomy completion

The pericardium overlying the heart and the great vessels is opened and stay sutures are used to secure the edge of the pericardium to the patient's skin. This holds the pericardial cavity open, improving the extent of the access and holds the cavity steady, improving ease of access. Each pericardial stay suture is made with a length of braided surgical suture A single pass of the needle through the pericardium is immediately followed by a pass of that same needle through the skin. The needle and suture are drawn through and then the suture is tied. Prior to cannulation, the pericardotomy is assessed. There is room enough here for the diverticulum to be accessed but the remnants of the thymus continue to obstruct access to the great vessels and require removal. The thymus of this patient extends behind the brachiocephalic vein. You can see it here being removed from the space that it occupies behind the left brachiocephalic vein and the front of the top of the pericardium. Once the thymectomy has been completed the top of the pericardium can be opened and purse strings for cannulation placed.