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Patch Angioplasty in the Rat Aorta or Inferior Vena Cava
Published on: February 27, 2017
Management of central coronary sinus ruptures using the pericardial patch repair technique
Clemens Aigner1, Ernst Wolner, Werner Mohl
1Department of Cardio-Thoracic Surgery, Medical University of Vienna, Vienna, Austria.
Insights
A novel pericardial patch technique safely repairs rare intraoperative coronary sinus ruptures. This method provides excellent bleeding control and avoids narrowing, leading to successful patient outcomes.
Area of Science:
- Cardiac Surgery
- Vascular Repair
- Surgical Innovation
Background:
- Intraoperative coronary sinus rupture is a rare but serious complication.
- Management of coronary sinus injury is technically challenging.
- Effective repair requires bleeding control without sinus narrowing.
Observation:
- A retrospective review of four cases (1996-2005) of intraoperative coronary sinus injury.
- Patients underwent valve replacement and/or coronary artery bypass surgery.
- A double pericardial patch technique with fibrin glue was employed for repair.
Findings:
- The pericardial patch repair technique was successful in all four patients.
- Patients experienced short postoperative recovery times, including early extubation and ICU discharge.
- Median follow-up of 33 months showed all patients alive with no echocardiographic signs of coronary sinus impairment.
Implications:
- The pericardial patch technique is a safe and feasible option for central coronary sinus ruptures.
- This method achieves excellent bleeding control.
- The technique appears to prevent long-term complications related to coronary sinus repair.
Background:
Intraoperative coronary sinus rupture is a rare event; however, it carries potential mortality and its' management is technically challenging. A repair technique should provide adequate bleeding control while avoiding narrowing or stricture of the coronary sinus.
Methods:
We retrospectively review our experience with a new pericardial patch repair technique. From January 1996 to May 2005 four cases of intraoperative coronary sinus injury were identified. Three female patients and one male patient with a mean age of 74 +/- 4 years underwent valve replacement and/or coronary artery bypass on cardiopulmonary bypass. A double pericardial patch technique sandwiched with human fibrin glue was used to cover the defect.
Results:
In all patients treated with this method, the injury could be treated successfully. All patients were extubated on the first postoperative day and median intensive care unit stay was 3 days. Drains could be removed after 4 days median. Median hospital stay was 13 days. After a median follow-up of 33 months all patients are alive without any echocardiographic signs of impairments of the coronary sinus.
Conclusions:
We conclude that the pericardial patch technique is a safe and technically feasible technique for repair of central coronary sinus ruptures. Excellent bleeding control and, in our experience, no consecutive complications were observed.
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