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Hydrodissection in chronic pulmonary endarterectomy.

Seetharama Padebettu Subramanya Bhat1, Chirag Sumithra Prasannakumar1, Tejal Joshi1

  • 1Department of Cardiothoracic and Vascular Surgery, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India.

Indian Journal of Thoracic and Cardiovascular Surgery
|February 14, 2023
PubMed
Summary

This study introduces hydrodissection using a carbon dioxide (CO2) mist blower during pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. This technique enhances thrombic load clearance with standard surgical tools.

Keywords:
CO2 mist blowerChronic pulmonary thromboembolic pulmonary hypertension (CTEPH)HydrodissectionPulmonary endarterectomy

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Area of Science:

  • Cardiovascular Surgery
  • Pulmonary Hypertension
  • Surgical Innovation

Background:

  • Chronic thromboembolic pulmonary hypertension (CTEPH) necessitates surgical intervention.
  • Pulmonary endarterectomy is a key treatment for CTEPH.
  • Optimizing thrombotic material removal is crucial for surgical success.

Purpose of the Study:

  • To evaluate the efficacy of hydrodissection using a carbon dioxide (CO2) mist blower in pulmonary endarterectomy.
  • To assess the potential of this technique to improve thrombotic load clearance.
  • To integrate a novel hydrodissection method using readily available surgical equipment.

Main Methods:

  • Surgical pulmonary endarterectomies were performed for CTEPH.
  • A carbon dioxide (CO2) mist blower, typically used in off-pump coronary artery bypass (OPCAB) surgery, was employed for hydrodissection.
  • Standard cardiac surgical instruments were utilized alongside the CO2 mist blower.

Main Results:

  • The hydrodissection technique facilitated enhanced clearance of thrombotic material.
  • The method integrated seamlessly with existing surgical procedures and instruments.
  • Optimal removal of thrombotic load was achieved.

Conclusions:

  • Hydrodissection with a CO2 mist blower is a viable adjunct to pulmonary endarterectomy for CTEPH.
  • This technique offers an effective means to improve thrombotic clearance using basic cardiac surgical instruments.
  • The approach represents a valuable innovation in surgical management of CTEPH.