TWilliam2019
Guru
Redundant right coronary aortic valve cusp, no aortic valve mass
Aortic and right atrial pursestring sutures were placed and following satisfactory heparinization as measured by ACT greater than 450 seconds aortic and right atrial cannulation were effected and cardiopulmonary bypass was established. The aorta was crossclamped and cold sanguinous cardioplegia was infused into the aortic root and diastolic arrest promptly ensued. Additional myocardial protection was achieved using topical slush.The aortic root was opened in the usual manner. Aortic valve was carefully and meticulously evaluated and findings are described above. Rewarming was carried out. Aortotomy was closed using a double layer of 4-0 Prolene. Volume was then infused into the patient and air was evacuated from the left side of the heart and ascending aorta. The pericardial well was flooded with carbon dioxide at 10 L/m throughout the entire open part of the procedure. Strong suction was then placed in the needle vent and the aortic cross-clamp was released and rewarming was carried out. The heart returned to spontaneous sinus rhythm. Following satisfactory rewarming cardiopulmonary bypass was gradually discontinued until satisfactory ejection was occurring and aggressive de-airing maneuvers were carried out in the usual standardized manner. Bypass was then completely discontinued and satisfactory rhythm and hemodynamics ensued. TEE findings are described above. Protamine was administered and decannulation was effected. With satisfactory hemodynamics, sinus rhythm, and hemostasis the chest was closed in layers. PA-C performed the sternal wound closure. A sterile Dermabond dressing was applied, sponge count was correct x2 and the patient was then transported to the CVRU in stable condition.
Aortic and right atrial pursestring sutures were placed and following satisfactory heparinization as measured by ACT greater than 450 seconds aortic and right atrial cannulation were effected and cardiopulmonary bypass was established. The aorta was crossclamped and cold sanguinous cardioplegia was infused into the aortic root and diastolic arrest promptly ensued. Additional myocardial protection was achieved using topical slush.The aortic root was opened in the usual manner. Aortic valve was carefully and meticulously evaluated and findings are described above. Rewarming was carried out. Aortotomy was closed using a double layer of 4-0 Prolene. Volume was then infused into the patient and air was evacuated from the left side of the heart and ascending aorta. The pericardial well was flooded with carbon dioxide at 10 L/m throughout the entire open part of the procedure. Strong suction was then placed in the needle vent and the aortic cross-clamp was released and rewarming was carried out. The heart returned to spontaneous sinus rhythm. Following satisfactory rewarming cardiopulmonary bypass was gradually discontinued until satisfactory ejection was occurring and aggressive de-airing maneuvers were carried out in the usual standardized manner. Bypass was then completely discontinued and satisfactory rhythm and hemodynamics ensued. TEE findings are described above. Protamine was administered and decannulation was effected. With satisfactory hemodynamics, sinus rhythm, and hemostasis the chest was closed in layers. PA-C performed the sternal wound closure. A sterile Dermabond dressing was applied, sponge count was correct x2 and the patient was then transported to the CVRU in stable condition.