- Email: [email protected]
Surgery for Congenital Heart Defects, second edition
Ann Thorae Surg 1994;58:252-3
sequences by further injuring the aorta. In contradistinction, the bodice, by constricting the aorta at a very specific level, provides security by decreasing tension at the site. We, therefore, limit our total number of sutures at the aortic cannulation site to three: two original concentric sutures and one repair suture-the latter in double pledget mattress configuration in a cephalocaudal orientation to avoid "hourglass" deformity of the aorta. If there is continued bleeding, or if the integrity of the aortic closure is in question, we employ the bodice technique to reinforce the aorta.
HOW TO DO IT SANCHEZ ET AL BODICE FOR CONTROL OF AORTIC BLEEDING
253
The bodice should not replace proper cannulation technique, and suture repair as described should precede its application. In our experience, this approach has been effective in arresting discrete bleeding from the cannulation site.
Reference 1. Buxton B, Harlan BJ, Cooley DA. Surgical treatment of fusiform thoracic aortic aneurysms by external reinforcement. Cardiovasc Dis Bull Tex Heart Inst 1976;3:35-41.
REVIEW OF RECENT BOOKS Surgery for Congenital Heart Defects, second edition By J. Stark, MD, and M. de Leoal, MD Philadelphia, Saunders, 1994 712 pp, illustrated, $245.00
Reviewed by Ross M. Llngerleider, MD It has been approximately one decade since the first edition of
Stark and de Leval's Surgery for Congenital Heart Defects became available. The first edition helped to herald the subspecialty nature of pediatric cardiac surgery. The second edition emphasizes the numerous technical and multidisciplinary refinements within this field that make it truly a subspecialty in the 1990s. The second edition of this book contains several new chapters including Echocardiography, Foetal Echocardiography, Interventional Catheterization in Pediatric and Congenital Heart Disease, Interruption of the Aortic Arch, Absent Pulmonary Valve Syndrome, Intraventricular Repair of Anomalies of VentriculoArterial Connection (REV procedure), The Arterial Switch Operation, Surgery for Hypoplastic Left Heart Syndrome, Surgery for Arrhythmias, and Heart and Heart-Lung Transplantation. As mentioned in their preface to this edition, the chapters on perfusion, pacemakers, pulmonary stenosis, pulmonary atresia with intact ventricular septum, surgery of the left ventricular outflow tract, right heart bypass operations, and atrial ventricular septal defects have been completely rewritten. The remainder of the text and many of the illustrations have been revised and updated to reflect the current practices of the authors who have contributed to this edition. The illustrations have retained the same quality as those in the
first edition and provide a unique blend of anatomic accuracy with simplicity that can only be created by those with extensive experience in the field. The section on perfusion techniques is current and updated to include comments about blood cardioplegia, retrograde coronary sinus perfusion, blood gas strategies used during cooling, and even postbypass methodology for ultrafiltration. Sprinkled throughout the text are numerous new illustrations for techniques that were not included in the first edition including extended end-to-end resection for repair of aortic coarctation, primary one-stage repair of interrupted aortic arch, multiple uses of homografts for right ventricular and left ventricular outflow tract reconstruction, techniques for total caval pulmonary connection in Fontan, the arterial switch procedure (including suggestions for dealing with complex anatomy), the REV procedure for pulmonary atresia plus ventricular septal defect, and many others. This edition also contains more outcome information than was available in the first edition, and many of the chapters are complemented by recently tabulated results from the authors' experience. Although each practicing congenital heart surgeon may have evolved technical differences with many of these procedures, this book provides a compendium of experience for what has worked well for the contributing authors. Many of the suggestions and illustrations provide reasonable options for handling difficult problems that we might encounter in our own practice. This book is timely, thorough, well organized, and a highly recommended addition to the library of any surgeon who practices congenital heart surgery in 1994.
Durham, North Carolina
sequences by further injuring the aorta. In contradistinction, the bodice, by constricting the aorta at a very specific level, provides security by decreasing tension at the site. We, therefore, limit our total number of sutures at the aortic cannulation site to three: two original concentric sutures and one repair suture-the latter in double pledget mattress configuration in a cephalocaudal orientation to avoid "hourglass" deformity of the aorta. If there is continued bleeding, or if the integrity of the aortic closure is in question, we employ the bodice technique to reinforce the aorta.
HOW TO DO IT SANCHEZ ET AL BODICE FOR CONTROL OF AORTIC BLEEDING
253
The bodice should not replace proper cannulation technique, and suture repair as described should precede its application. In our experience, this approach has been effective in arresting discrete bleeding from the cannulation site.
Reference 1. Buxton B, Harlan BJ, Cooley DA. Surgical treatment of fusiform thoracic aortic aneurysms by external reinforcement. Cardiovasc Dis Bull Tex Heart Inst 1976;3:35-41.
REVIEW OF RECENT BOOKS Surgery for Congenital Heart Defects, second edition By J. Stark, MD, and M. de Leoal, MD Philadelphia, Saunders, 1994 712 pp, illustrated, $245.00
Reviewed by Ross M. Llngerleider, MD It has been approximately one decade since the first edition of
Stark and de Leval's Surgery for Congenital Heart Defects became available. The first edition helped to herald the subspecialty nature of pediatric cardiac surgery. The second edition emphasizes the numerous technical and multidisciplinary refinements within this field that make it truly a subspecialty in the 1990s. The second edition of this book contains several new chapters including Echocardiography, Foetal Echocardiography, Interventional Catheterization in Pediatric and Congenital Heart Disease, Interruption of the Aortic Arch, Absent Pulmonary Valve Syndrome, Intraventricular Repair of Anomalies of VentriculoArterial Connection (REV procedure), The Arterial Switch Operation, Surgery for Hypoplastic Left Heart Syndrome, Surgery for Arrhythmias, and Heart and Heart-Lung Transplantation. As mentioned in their preface to this edition, the chapters on perfusion, pacemakers, pulmonary stenosis, pulmonary atresia with intact ventricular septum, surgery of the left ventricular outflow tract, right heart bypass operations, and atrial ventricular septal defects have been completely rewritten. The remainder of the text and many of the illustrations have been revised and updated to reflect the current practices of the authors who have contributed to this edition. The illustrations have retained the same quality as those in the
first edition and provide a unique blend of anatomic accuracy with simplicity that can only be created by those with extensive experience in the field. The section on perfusion techniques is current and updated to include comments about blood cardioplegia, retrograde coronary sinus perfusion, blood gas strategies used during cooling, and even postbypass methodology for ultrafiltration. Sprinkled throughout the text are numerous new illustrations for techniques that were not included in the first edition including extended end-to-end resection for repair of aortic coarctation, primary one-stage repair of interrupted aortic arch, multiple uses of homografts for right ventricular and left ventricular outflow tract reconstruction, techniques for total caval pulmonary connection in Fontan, the arterial switch procedure (including suggestions for dealing with complex anatomy), the REV procedure for pulmonary atresia plus ventricular septal defect, and many others. This edition also contains more outcome information than was available in the first edition, and many of the chapters are complemented by recently tabulated results from the authors' experience. Although each practicing congenital heart surgeon may have evolved technical differences with many of these procedures, this book provides a compendium of experience for what has worked well for the contributing authors. Many of the suggestions and illustrations provide reasonable options for handling difficult problems that we might encounter in our own practice. This book is timely, thorough, well organized, and a highly recommended addition to the library of any surgeon who practices congenital heart surgery in 1994.
Durham, North Carolina