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Published on: June 14, 2015
Sutureless hemostasis of a coronary sinus rupture with Hydrofit
Yoshinori Nakahara1, Takeyuki Kanemura1
1Department of Cardiovascular Surgery, IMS Katsushika Heart Center, 3-30-1 Horikiri, Katsushika Ward, Tokyo, 124-0006 Japan.
Insights
Coronary sinus rupture (CSR) is a rare surgical complication. A novel technique using sealant and a pericardium patch achieved rapid, effective repair on a beating heart.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Aortic Surgery
Background:
- Coronary sinus rupture (CSR) is a rare but serious complication during cardiac surgery.
- Standardized treatment protocols for CSR are lacking, necessitating innovative approaches.
Observation:
- A 68-year-old male patient developed CSR during total arch replacement for type A acute aortic dissection.
- The rupture occurred during coronary sinus cannulation for retrograde cardioplegia.
Findings:
- A novel, clampless, and sutureless repair technique was successfully employed on the beating heart.
- An elastomeric sealant combined with a bovine pericardium patch achieved complete hemostasis within 2 minutes of manual compression.
Implications:
- This technique offers a simple, fast, and effective method for managing coronary sinus rupture.
- The approach may reduce operative time and improve patient outcomes in complex aortic surgeries.
Abstract:
Coronary sinus rupture (CSR) is a rare operative complication, and a standard procedure for its treatment has not been established. We report successful repair of a CSR in a 68-year-old man who underwent total arch replacement for type A acute aortic dissection. CSR was caused by the coronary sinus cannulation for retrograde cardioplegia and was detected during cardiopulmonary bypass weaning. We applied an elastomeric sealant with a bovine pericardium patch on the beating heart. After manual compression for 2 min, complete hemostasis was achieved. A clampless and sutureless hemostasis for repairing coronary sinus rupture is a simple, fast, and effective technique.
