cardiopulmonary bypass technique  

aortic cannulation

- aortic cannulation มีเทคนิคการทำอย่างไร

aortic cannulation มีเทคนิคการทำอย่างไร

- arterial cannulation proximal and to the left of the innominate artery origin.

 

- two opposing diamond-shaped pursestrings are placed using two double-armed 3-0 polypropylene sutures.

- the depth of the bites should be into the media of the aortic wall.

- the size of pursestring should be one third greater than the diameter of the cannula tip.

 

- วิธีการเลือก size of aortic cannulation

 

** ก่อนจะ aortic cannulation

- SBP < 100 mmHg

- ACT > 400 sec

 

- placing a tonsil forceps on the aortic epicardial fat pad

- A no 15 blade scalpel is passed into the aorta to create a transverse incision that is equal to the diameter of the cannula

 

- once the cannula is in place, the pursestrings are snugged tight, the cannula is secured to one of the pursestring tourniquets.

- arterial line is connected.

venous cannulation

- venous cannulation มีเทคนิคการทำอย่างไร

venous cannulation มีเทคนิคการทำอย่างไร

type of venous cannulation

-two-stage cavoatrial cannulation

- bicaval venous cannulation

 

two-staged cavoatrial cannulation

two-staged cavoatrial cannulation

** no entry into the right heart or exposure of the mitral valve : two-stage cavoatrial cannula

 

- A 3/0 polypropylene pursestring suture is placed in the right atrial appendage.

** avoid right atrioventricular groove and sinotubular junction.

 

 

- opening the atrial appendage within the pursestring with scissors.

- the cannula is inserted caudally, posteriorly, and slightly laterally and passes into the IVC.

 

- the pursestring is snugged and the cannula secured with a heavy silk tie.

bicaval venous cannulation

bicaval venous cannulation

- entry to the right heart or exposure to mitral valve anatomy

 

- the pursestring for superior caval cannulation is usually placed in the right atrial appendage.

- the inferior caval pursestring is placed in the inferior aspect of the right atrium approximately 2 cm above the cavoatrial junction.

cardioplegia

- retrograde cardioplegia

- antegrade cardioplegia

 

retrograde cardioplegia

- retrograde cardioplegia มีเทคนิคการทำอย่างไร

retrograde cardioplegia มีเทคนิคการทำอย่างไร

- A 4/0 polypropylene pursestring is placed in the anterior aspect of the right atrium.

 

- An incision is made within the pursestring, and the cannula is inserted into the atrium anteior to the venous cavoatrial line.

 

 

- the cannula is then passed into the coronary sinus by advancing the cannula in the line of its curvature with the tip pointing toward the patient's left shoulder.

 

 

- the cannula is deaired, and the cardioplegic and pressure-monitoring lines are connected.