RESUMEN
The optimal technique for myocardial protection and cardioplegia delivery during totally endoscopic robotic surgery is still under evolution. Cardioplegia delivery with endovascular clamping of the aorta is a common method used for this purpose but has several disadvantages and may lead to serious complications. Here we describe an alternative cardioplegia delivery method during totally endoscopic atrial septal defect closure and mitral valve repair. The method using a transthoracic aortic clamp and an antegrade cardioplegia cannula without any thoracotomy seems to be a safe and reproducible technique, which may enhance myocardial protection and prevent some of the complications of the endoclamp technique during robotically assisted cardiac surgery.
Asunto(s)
Soluciones Cardiopléjicas/administración & dosificación , Puente Cardiopulmonar/métodos , Defectos del Tabique Interatrial/cirugía , Válvula Mitral/cirugía , Robótica/métodos , Cirugía Asistida por Computador/métodos , Toracoscopía/métodos , Aorta Torácica , Puente Cardiopulmonar/instrumentación , Diseño de Equipo , Humanos , Robótica/instrumentación , Cirugía Asistida por Computador/instrumentación , Instrumentos Quirúrgicos , Toracotomía/instrumentación , Toracotomía/métodosRESUMEN
Mechanical heart valve thrombosis during pregnancy is a challenging condition. We present a pregnant patient with stuck mechanical mitral valve. During the 36th week of pregnancy, she was admitted to our emergency clinic because of aggravated dyspnea, tachypnea, and cyanosis. Echocardiography revealed stuck mechanical valve in mitral position and she was diagnosed with acute left ventricular heart failure due to mechanical valve thrombosis. Reoperative mitral valve replacement was performed in emergency conditions immediately following Cesarean section. She and her baby were discharged 11 days after surgery without complications.
