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Surgically implanted infusion ports are placed below the clavicle (infraclavicular fossa), with the catheter threaded into the heart (right atrium) through a large vein. Once implanted, the port is accessed via noncoring "Huber" needles inserted through the skin. The health care provider may need to use topical anesthetic before accessing the port.
The port access site is fixed at 5 cm below the midline of the clavicle and 9 to 10 cm lateral to the midline of the chest. Then, a 5 to 6 cm incision is made to create a subcutaneous tissue pouch for the placement of port access site. A tunnel is made from the port access site until adjacent to the internal jugular neck wound.
CABG is the best procedure to reduce mortality from severe CAD and improve quality of life. [31] [32]: 153 Operative mortality strongly relates to the patient's age. According to a study by Eagle et al., patients 50–59 years old have an operative mortality rate of 1.8%, while patients older than 80 have a rate of 8.3%. [33]
The Nuss procedure is a minimally invasive procedure, invented in 1987 by Dr. Donald Nuss and his colleagues, Dr. Daniel Croitoru and Dr. Robert Kelly, for treating pectus excavatum. [1] [2] [3] He developed it at Children's Hospital of The King's Daughters, in Norfolk, Virginia. The operation typically takes approximately two hours. [4]: 1277
MIDCAB is sometimes referred to as "keyhole" heart surgery because the operation is analogous to operating through a keyhole. MIDCAB is a form of off-pump coronary artery bypass surgery (OPCAB), performed "off-pump" – without the use of cardiopulmonary bypass (the heart-lung machine).
This procedure makes heart surgery possible for patients who were previously considered too high risk for traditional surgery due to age or medical history. [5] [6] Patients referred for this procedure may have coronary artery disease (CAD); aortic, mitral or tricuspid valve diseases; or previous unsuccessful stenting.
Video-assisted thoracoscopic surgery (VATS) is a type of minimally invasive thoracic surgery performed using a small video camera mounted to a fiberoptic thoracoscope (either 5 mm or 10 mm caliber), with or without angulated visualization, which allows the surgeon to see inside the chest by viewing the video images relayed onto a television screen, and perform procedures using elongated ...
The procedure can also be used to measure pressures in the heart chambers. The pulmonary artery catheter allows direct, simultaneous measurement of pressures in the right atrium, right ventricle, pulmonary artery, and the filling pressure ( pulmonary wedge pressure ) of the left atrium.