3-dimensional right ventricular volume assessment.

PURPOSE: The purpose of this review was to evaluate new computer software available for 3-dimensional right ventricular (RV) volume estimation. DESCRIPTION: Based on 2-dimensional echocardiography, various algorithms have been used for RV volume estimation. These are complex, time-consuming techniques and are prone to significant error. The current clinical paradigm of RV volume assessment is based on the visual quantitative assessment of chamber size and the use of tricuspid annular and RV internal diameters as a surrogate measure of RV volume. Hence, there is a need for a practical method for the intraoperative assessment of RV volume. EVALUATION: The evaluation consists of an objective review of the capabilities of this software and its potential application in the operating room. The authors also performed a detailed review of the potential limitations and possible improvements. CONCLUSIONS: This new software has the potential to be incorporated into the existing workflow environment of the ultrasound systems in the future, making it clinically feasible to perform perioperative RV volume analysis.

Novel hemostatic patch achieves sutureless epicardial wound closure during complex cardiac surgery, a case report.

Treatment of damaged cardiac tissue in patients with high bleeding tendency can be very challenging, damaged myocardial tissue has a high rupture risk when being sutured subsequently on-going bleeding is a major risk factor for poor clinical outcome. We present a case demonstrating the feasibility in using a novel haemostatic collagen sponge for the management of a myocardial wound. This report is the first description in cardiac surgery where Hemopatch sponges are used to successfully seal a left ventricle wound. Our patient was diagnosed with endocarditis, had a low pre-operative haemoglobin count and underwent cardiac surgery for multiple valve repairs. The procedure was performed on cardiopulmonary bypass, which meant our patient had to be heparinized. Despite these major risk factors for bleeding Hemopatch managed to contain bleeding and seal the wound, no sutures were needed.

Sutureless management of left ventricle wall rupture; a series of three cases.

Treatment of left ventricle wall rupture is very challenging, ruptured myocardial tissue is usually of poor quality and has a high risk of total rupture when being sutured. Furthermore, rapid decision-making is needed under stressful conditions. We present a series of three cases demonstrating the feasibility of using only hemostatic collagen sponges for the management of left ventricle wall rupture. All patients we Caucasian males, two patients were 65 years and one patient was 67 years old at the time of surgery. This report contains the first video images of solely use of hemostatic collagen sponges to seal a left ventricle wall rupture. Implication of our case series could be that the indication to use hemostatic collagen sponges, could be broadened towards other surgical specialties where suturing ruptured tissue can be difficult.