Hellow guys, Welcome to my website, and you are watching Gastroepiploic artery harvesting for CABG. and this vIdeo is uploaded by Chirurgie Cardiaque CHU Grenoble at 2014-03-10T05:35:07-07:00. We are pramote this video only for entertainment and educational perpose only. So, I hop you like our website.
| Name | Gastroepiploic artery harvesting for CABG |
| Video Uploader | Video From Chirurgie Cardiaque CHU Grenoble |
| Upload Date | This Video Uploaded At 10-03-2014 12:35:07 |
| Video Discription | The superiority of arterial grafts for myocardial revascularization led surgeons to commonly use both internal thoracic artery and increasingly frequent use the gastroepiploic artery (GEA) to reach coronary arteries on the inferior ventricular wall. Other advantage of this conduit is that it is a pedicled graft, allowing avoidance of manipulation of the aorta (no reimplantation and lateral aortic cross clamping), using an OPCAB technique (see video: http://www.youtube.com/watch?v=IERY3HrX8VY). It is harvested in about 15 minutes, with only a few centimeters more at the low part of sternotomy, avoiding leg or arm incision. After internal thoracic artery harvesting, spreading the sternum and opening the pericardium, target coronary vessels are explored to confirm the recipient vessel, particularly when the right coronary artery is thrombosed on angiography. Then the GEA is dissected on a pedicle from the pylorus to the middle of the greater curvature of the stomach. Due to its muscular histologic status, the GEA is a highly vasoactive artery that is ****e to spasm. The main GEA drawback concerns flow: the degree of coronary stenosis is a very important factor, and the GEA must be used only in cases of thrombosed or very tight stenosis of the right coronary artery. The size of the GEA graft, relative to the recipient coronary artery, is also a very important factor to avoid flow competition with the recipient artery. Finally, an adequate preparation is required: papaverine sprayed on the pedicled graft, with distal placement of a metal clip allowing maximal dilation of the conduit (combined effect of papaverine and of mechanical effect induced by arterial pressure). The pedicle is cut at the last moment either before dissection of the coronary artery, in beating heart surgery, or before starting the cardiopulmonary bypass in on-pump operations. In spite of this careful preparation, if the graft is not satisfactory it is immediately sacrificed. Pr Olivier Chavanon, Cardiac Surgery Department, Grenoble University Hospital, Faculté de médecine Université Joseph Fourier. Music generated by Pinacle Studio software. |
| Category | Science & Technology |
| Tags | coronary artery bypass surgery | CABG | pontage | coronaire | coronarien | artère | gastroépiploique | gastroepiploic | artery | prélèvement | conduit | greffon | artériel | pédiculé | harvesting | graft | arterial | Chirurgie Cardiaque | CHU | Grenoble | Chirurgien | pedicled | papaverin | droite | right | revascularisation | coronary | bypass | gastro | gastro-omental |
