Use of Venous Fistula Technique for Intraoperative Cardiac Hemorrhage

Nielson, David H.; Sutter, Philippe De; Goldman, Scott

doi:10.1111/j.1540-8191.1993.tb00413.x

Cited by 5 publications

(2 citation statements)

References 2 publications

(1 reference statement)

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“…Drugs commonly used to decrease blood loss are aprotinin, epsilon-aminocaproic acid, and tranexamic acid. Nielson et al [94] described an innovative technique to control haemorrhage after right atrial reconstruction with a pericardial patch in a patient with primary angiosarcoma. A Dacron patch was initially placed around the right atrium and ventricle to tamponade the bleeding.…”

Section: Management Of Bleedingmentioning

confidence: 99%

Primary cardiac sarcoma

Shanmugam¹

2006

European Journal of Cardio-Thoracic Surgery

132

157

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Primary malignant lesions of the heart are rare. Although myxomas have been extensively described, there is a paucity of large studies on non-myxomatous cardiac tumours. On the other hand, there are several case reports on specific histopathological variants, in small numbers. Consequently there exists no consensus on therapeutic modalities for cardiac sarcomas. The prognosis for these lesions remains dismal, despite the enhanced diagnostic ability of newer technology. The reasons for the dismal prognosis are (1) the advanced tumour stage at presentation, (2) non-specific symptomatolgy, (3) insufficient awareness of these lesions, due to their rarity, (4) delayed diagnosis and/or misdiagnosis, which leads to (5) advanced tumour stage at presentation. Thus a vicious cycle is created. This article addresses these issues, deals with the surgically relevant modes of presentation, rather than the histopathology, and reviews the diagnosis and management options for the various sarcomas, categorized by the site and extent of cardiac involvement. Clinicians should be familiar with the presentation of these tumours and have a high index of suspicion, since the potential for long-term survival following resection does exist. Wide surgical resection remains the cornerstone of sarcoma therapy. Complete characterization of tumour extent using echocardiography and CT/MRI is mandatory to achieve this goal. Radical resections such as 'bench surgery' and transplantation may reduce local recurrence, but the risk of metastatic disease remains. The clinical experience with such approaches is limited. The role of adjuvant therapy is not yet established. In no other field of cardiac surgery would a multidisciplinary approach be more useful, in achieving cure or long-term palliation.

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Section: Management Of Bleedingmentioning

confidence: 99%

Primary cardiac sarcoma

Shanmugam¹

2006

European Journal of Cardio-Thoracic Surgery

132

157

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“…Construction of an aorta-to-right atrium (RA) fistula, initially described by Cabrol in his 1981 report of the aortic root replacement procedure itself, 1 has since been supported by other authors as well for control of intractable bleeding at the time of aortic root, ascending aortic, and aortic arch surgery. 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 In these cases, the Cabrol fistula was applied for its often-remarkable potential to correct an unsustainable bleeding situation. 1 The technique involves capping the bleeding area with a patch (usually pericardium) and funneling the shed arterial blood from the perigraft space to the venous system (RA or innominate vein).…”

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confidence: 99%