Comprehensive Surgical Management of Congenital Heart by Richard A Jonas

By Richard A Jonas

This e-book is the 1st unmarried authored textbook masking the full spectrum of surgical administration of congenital middle sickness. the writer, Dr. Richard Jonas, is the manager of Cardiovascular surgical procedure at kid's sanatorium Boston and the fourth William E Ladd Professor of surgical procedure at Harvard scientific university. administration of congenital middle ailment this present day calls for a collaborative attempt by means of a wide healthcare crew together with congenital cardiac surgeons but additionally pediatric cardiologists, pediatric cardiac intensivists, pediatric cardiac anesthesiologists, perfusion and breathing technicians and pediatric nurses. All of those contributors must have a transparent figuring out of the surgical manipulations that happen within the working room. This textbook presents superbly illustrations that in actual fact depict even the main advanced approaches. yet this e-book is far greater than an operative atlas. It provides evidence-based medication that gives various medical citations which clarify not just how an operation could be performed but additionally whilst and why it's going to be performed and the results of those interventions.

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The blend will need to be varied depending on the tissue characteristics. For example, the woody edematous planes that are found in the child who has had a bidirectional Glenn shunt are best developed with a predominantly coagulation current with appropriate counter traction developed between the surgeon and assistant to open the plane. A strong coagulation current is often useful when taking lung adhesions down because very vascular adhesions will have developed, particularly to the heart itself but also to the chest wall.

After the pulmonary arteries have been harvested from the truncus by transecting the trunk one could then choose to reanastomose the aorta. But a better approach is to perform the distal anastomosis of the homograft while the aorta is divided. The exposure of the homograft to pulmonary artery bifurcation is immeasurably better when the surgeon does not have to work over and behind the aorta. And of course the homograft must have been selected, thawed and rinsed by the time it is needed so this should have been done at an earlier phase of the procedure.

The congenital heart surgeon bears witness to the truth of these words many times in a career. On the other hand there is no greater reward than to be able to save a child from the certain death threatened by a serious congenital cardiac malformation. It is this fact, and the fundamental knowledge that one has made every possible effort to do one’s best for every child, that allows the congenital cardiac surgeon to carry the weight of those who do not survive. Congenital cardiac surgery offers not only emotional and psychological challenges but also physical ones.

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