Pericardial resection

A surgical treatment for constrictive pericarditis. Precautions for pericardial resection: 1. Cardiac arrest is prone to occur during the induction period of anesthesia. It is required to be stable and to avoid hypoxia. Intubation should be performed quickly and artificial respiration should be performed in time to avoid hypotension during anesthesia and surgery. It should be ensured that hypoxemia does not occur during the operation. In addition to ECG monitoring, blood gas analysis monitoring is also required. 2. It is inevitable to compress the heart when peeling the pericardium. To avoid excessive prolonged compression, if frequent premature beats occur, the operation should be suspended to avoid severe heart rhythm disturbance. 3. When the calcification is serious and multiple peeling is difficult, multiple # -shaped incisions can be used to remove only the part that may be removed, leaving the non-peelable part in an island shape on the myocardium. Do not blindly pursue complete removal. 4. When pus is found in some pericardial cavity, or a layer of unorganized granulation is attached to the surface of the heart, pus, necrosis should be removed, and granulation tissue should be stripped as patiently as possible; you can also take # -shaped strip to avoid future The granulation tissue is mechanized to form new constrictions. 5. The atrioventricular sulcus should be fully released. If it is impossible to completely remove it, it should also be intermittently released to prevent the interventricular passage from being blocked, but it should be handled carefully to avoid damaging the coronary vessels. No conventional stripping is performed at the entrance of the upper and lower chambers unless there is evidence of compression. The upper cavity is rarely oppressed. The fiber ring at the entrance of the inferior cavity can be probed into the fiber ring to protect the inferior vena cava, and the fiber ring is sharply peeled off and then cut to release the pressure on the inferior vena cava. Remove the fiberboard. 6. Intraoperative blood loss should be supplemented in an appropriate amount to avoid overdose. Fluid input should be strictly restricted to avoid excessive fluid load and cause left heart failure.