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Nedavni intervju (podcast) u Univerzitetskom kliničkom centru Banja Luka, Republika Srpska.
Jutarnji program RTS-a 12.03.2024.
Coronary artery bypass grafting versus percutaneous coronary intervention in single-vessel left anterior descending artery disease: mid-term propensity matching study
Clipless skeletonized internal mammary artery harvesting with harmonic technology
Zivojin S Jonjev 1, Aleksandar M Milosavljevic 2, Novica Kalinic 3, Adam Adam 4
Affiliations
- 1Institute for Cardiovascular Diseases of Vojvodina, Clinic of Cardiovascular Surgery, Sremska Kamenica, Serbia University of Banja Luka, Faculty of Medicine, Banja Luka, Republic of Srpska, Bosnia & Herzegovina.
- 2Institute for Cardiovascular Diseases of Vojvodina, Clinic of Cardiovascular Surgery, Sremska Kamenica, Serbia.
- 3University of Banja Luka, Faculty of Medicine, Banja Luka, Republic of Srpska, Bosnia & Herzegovina.
- 4Icahn School of Medicine at Mount Sinai JJP VAMC, New York, NY, USA.
Free article
Abstract
Since the introduction of the mammary artery harvesting procedure, electrocautery has been used as a standard method of care. However, mammary artery spasm, subadventitial haematoma and mammary artery damage due to clips dispositioning or high thermal energy injury have been recorded. To achieve a perfect mammary artery graft, we propose the usage of a high-frequency ultrasound device, usually recognized as a harmonic scalpel. It reduces thermal-related injuries, the use of clips and the risk of mammary artery spasm and/or dissection.
Keywords: CABG; Conduit harvesting; Harvesting technique; IMA harvesting; Internal mammary artery.
© The Author 2023. Published by MMCTS on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
Kardiohirurgija u UKC Banja Luka
ReReDo surgery due to acute aortic dissection
Acute aortic dissection (hemiarch repair in deep hypothermia)
Caucasian female 73 y/o was admitted to the hospital with acute aortic dissection. Transthoracic eco indicated that MR 4 and TR 3 were also present. After quick preop set up PT was urgently operated on. The dissected aorta was resected and hemiarch procedure was performed with implantation of the Vascutek #30 prosthesis. PT was in deep hypothermia (T=28C) and total circulatory arrest was established for 57 minutes. Brain was protected with cerebral anterograde perfusion through brachiocephalic trunk. MR and TR were also corrected by annuloplasty. The patient was discharged on the PO day #13 w/o complication. PT was doing well 3 month after surgery.
Preop view of the Aortic Dissection Arrangement of the proximal anastomosis with aortic cross clamp Tailoring of the graft and preparation for open distal anastomosis Final view after surgey
Resekcija gigantske koronarne aneurizme

- Pacijent star 68 godina primljen je zbog ishemijske bolesti srca
- Dijagnostičkom koronarografijom utvrđeno je postojanje višesudovne koronarne bolesti i gigantske koronarne aneurizme desne koronarne arterije

- CT koronarografijom potvrđeno je postojanje koronarne aneurizme i određena je njena topografija u odnosu na ostale srčane strukture.

- Urađena je hirurška revaskularizacija miokarda (3xCABG-ACDpd, LAD-lima, CxOM1) uz totalnu resekciju koronarne aneurizme.
- Pacijent je otpušten na dalji kućni oporavak 7. PO dana u dobrom opštem stanju i bez komplikacija.
Lepota i zdravlje, jul 2019.
