Use of venous fistula technique for intraoperative cardiac hemorrhage.

Abstract

We describe an innovative technique to control hemorrhage after right atrial wall reconstruction in a patient with primary angiosarcoma. At the time of surgery, the tumor was found to involve all of the free wall of the right atrium and a superficial layer of the right ventricle. A pericardial patch was used to reconstruct the right atrial wall; however, there was diffuse coagulopathy with bleeding from the anastomoses and remaining tumor. To tamponade the bleeding, a Dacron patch was sewn to the right edge of the pericardium, around the right ventricle and right coronary artery, but with little improvement in the bleeding. A type of Cabrol fistula was then formed with a tube graft from the Dacron patch to the left innominate vein. This acted as a conduit back into the venous system, with the blood taking the path of least resistance. Hemostasis was then achieved, allowing the patient to be taken to the intensive care unit.

• Authors: D H Nielson, F P Sutter, S M Goldman
• Journal: Journal of cardiac surgery (J Card Surg) Vol. 8 Issue 5 Pg. 558-61 (Sep 1993) ISSN: 0886-0440 [Print] United States
• PMID: 8219537 (Publication Type: Case Reports, Journal Article)

Chemical References

• Polyethylene Terephthalates

Topics

• Adult
• Blood Loss, Surgical
• Blood Vessel Prosthesis
• Brachiocephalic Veins (surgery)
• Female
• Heart Atria
• Heart Neoplasms (surgery)
• Heart Ventricles
• Hemangiosarcoma (surgery)
• Hemostasis, Surgical (methods)
• Humans
• Polyethylene Terephthalates
• Prostheses and Implants