Primer separador retráctil de pulmón para facilitar la disección extrapleural de la arteria torácica interna

Yoandy López-de la Cruz, Chenly Pedraza-González, Yolepsis F. Quintero-Fleites, Roger Mirabal-Rodríguez, Gustavo de J. Bermúdez-Yera, Alain Allende-González, Ernesto Chaljub Bravo, Rodolfo Morales Mato

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Resumen

La disección de la arteria torácica interna es uno de los procedimientos más definitorios de la cirugía de revascularización miocárdica, pues se ha demostrado que la calidad de vida y la evolución a corto y largo plazo de los pacientes dependerán de las características morfológicas del injerto. Hace más de 25 años se propuso la utilización de un separador pulmonar maleable para facilitar la disección de la arteria torácica interna, especialmente su segmento proximal, pero nunca se ha fabricado ese dispositivo. Se presenta un separador pulmonar manufacturado a partir de dispositivos en desuso, empleados en cirugía coronaria. Se comentan y discuten las principales ventajas demostradas durante más de tres años en cerca de un centenar de pacientes.

Referencias

van Wingerden JJ. Sternotomy and Intrathoracic Omentum: Two Procedures, Two Innovators, and the River That Runs Through It—A Brief History. Ann Thorac Surg. 2015;99:738-43.

Milton H. Mediastinal surgery. Lancet. 1897;1:872-5.

Milton H. Removal of a foreing body from the bronchus by intrathoracic tracheotomy. Lancet. 1901;1:242-4.

Shiffman MA, Low M. Recent Clinical Techniques, Results, and Research in Wounds. Berlín: Springer International Publishing; 2018.

van Wingerden JJ. Poststernotomy mediastinitis revisited. Amsterdam: Optima Grafische Communicatie; 2015.

Bains MS, Ginsberg RJ, Jones WG, McCormack PM, Rusch VW, Burt ME, et al. The Clamshell Incision: An Improved Approach to Bilateral Pulmonary and Mediastinal Tumor. Ann Thorac Surg. 1994;58:30-3.

Dalton ML, Connally SR, Sealy WC. Julian’s Reintroduction of Milton’s Operation Ann Thorac Surg. 1992;53:532-3.

Longmire WP, Cannon JA, Kattus AA. Direct vision coronary endarterectomy for angina pectoris. New Engl J Med. 1958;259:993-9.

López de la Cruz Y. William Polk Longmire Jr. y los primeros 60 años de la cirugía de puentes aorto-coronarios. CorSalud. 2018 Abr-Jun;10(2):158-63.

Sewell WH. The surgical treatment of coronary artery disease. Amer Surg. 1959;25:8.

Kieser TM, Roseb MS, Aluthman U, Narine K. Quicker yet safe: skeletonization of 1640 internal mammary arteries with harmonic technology in 965 patients. European Journal of Cardio-Thoracic Surgery. 2014;45:e142-e50. DOI: 10.1093/ejcts/ezu024.

Sewell WH, Sones FM, Fish RG, Joyner JT, Effler DB. The pedicle operation for coronary insufficiency: Technique and preliminary results. J Thorac Cardiovasc Surg. 1965;49:317-29

Mueller RL, Rosengart TK, Isom OW. The History of Surgery for Ischemic Heart Disease. Ann Thorac Surg. 1997;63:869-78.

Benedetto U, Altman DG, Gerry S, Gray A, Lees B, Pawlaczyk R, et al. Pedicled and skeletonized single and bilateral internal thoracic artery grafts and the incidence of sternal wound complications: Insights from the Arterial Revascularization Trial. J Thorac Cardiovasc Surg. 2016;152(1):270-6. http://dx.doi.org/10.1016/j.jtcvs.2016.03.056.

Satdhabudha O, Noppawinyoowong N. A randomized comparison of flow characteristics of semiskeletonized and pedicled internal thoracic artery preparations in coronary artery bypass. Journal of Cardiothoracic Surgery. 2017;12(28):7. DOI: 10.1186/s13019-017-0589-1.

Özülkü M, Aygün F. Effect of LIMA Harvesting Technique on Postoperative Drainage in Off-Pump CABG. Braz J Cardiovasc Surg. 2016;31(2):120-6. DOI: 10.5935/1678-9741.20160024.

Badia S, Berastegui E, Cámara ML, Delgado L, Fernández C, Julià I, et al. Revascularización miocárdica con uso de doble arteria mamaria interna y morbilidad esternal. Experiencia de un centro. Cir Cardiov. 2017;24(3):149-56. http://dx.doi.org/10.1016/j.circv.2016.11.049.

Raffa GM, Malvindi PG, Kowalewski M, Sansone F, Menicanti L. Training in Coronary Artery Bypass Surgery: Tips and Tricks of the Trade. Semin Thoracic Surg. 2017;29(2):137-42. http://dx.doi.org/10.1053/j.semtcvs.2017.01.015.

Galbut DL, Traad EA, Dorman MJ, DeWitt PL, Larsen PB, Kurlansky PA, et al. Seventeen-Year Experience With Bilateral Internal Mammary Artery Grafts Ann Thorac Surg. 1990;49:195-201.

Uzun A, Yener AÜ, Kocabeyoglu S, Çiçek, Ö F, Yasar E, Yener Ö, et al. Effects of pleural opening on respiratory function tests in cardiac surgery: a prospective study. European Review for Medical and Pharmacological Sciences. 2013;17:2310-7.

Bortolussi G, Bejko J, Gallo M, Comisso M, Carrozzini M, Guglielmi C, et al. Coronary Artery Bypass Grafting in Elderly Patients: Insights from a Comparative Analysis of Total Arterial and Conventional Revascularization. J of Cardiovasc Trans Res. 2016;9:223-9. DOI: 10.1007/s12265-016-9688-y.

Di Mauro M, Iacò AL, Acitelli A, D’Ambrosio G, Filipponi L, Salustri E, et al. Bilateral internal mammary artery for multi-territory myocardial revascularization: long-term follow-up of pedicled versus skeletonized conduits. Eur J Cardiothorac Surg. 2015;47:698-702. DOI: 10.1093/ejcts/ezu247.

Cunningham JM, Gharavi MA, Fardin R, Meek RA. Considerations in the skeletonization technique of internal thoracic artery dissection. Ann Thorac Surg. 1992;54:947-50.

Efthymiou CA, Weir WI. Optimisation of internal thoracic artery exposure using a simple retraction method for extrapleural dissection. Ann R Coll Surg Engl. 2015;97:157-64.

Charniot JC, Zerhouni K, Kambouchner M, Martinod E, Vignat N, Azorin J, et al. Persistent symptomatic pleural effusion following coronary bypass surgery: clinical and histologic features, and treatment. Heart Vessels. 2007;22:16-20. DOI: 10.1007/s00380-006-0930-4.

Dabbagh A. Postoperative Pain Management in Cardiac Surgery In: Dabbagh A, Esmailian F, Aranki SF, editors. Postoperative Critical Care for Cardiac Surgical Patients. Berlin: Springer; 2014. p. 257-94.

Schoeffler P, Chabanne R. Surgical Factors Influencing the Occurrence of Chronic Postsurgical Pain. In: Mick G, Guastella V, editors. Chronic Postsurgical Pain. Heidelberg: Springer; 2014. p. 59-73.

López-de la Cruz Y, Pedraza-González C, Quintero-Fleites YF, Mirabal-Rodríguez R, Bermúdez-Yera GJ, Allende-González A, et al. Beneficios inmediatos de la utilización de un separador pulmonar flexible durante la disección esqueletizada de la arteria mamaria interna. Cir Cardiov. 2019;26(2):98-103. https://doi.org/10.1016/j.circv.2018.07.005.

Oates M, Yadav s, Saxena P. Management of a Left Internal Thoracic Artery Graft Injury during Left Thoracotomy for Thoracic Surgery. Heart lung Circ. 2016;25(7):e75-e7. http://dx.doi.org/10.1016/j.hlc.2016.01.008.

Kanzaki R, Inoue M, Minami M, Shintani Y, Funaki S, Kawamura T, et al. Outcomes of lung cancer surgery in patients with coronary artery disease: a decade of experience at a single institution. Surgery Today. 2017;47(1):27-34. DOI: 10.1007/s00595-016-1355-z.

Maeda H, Kanzaki M, Sakamoto K, Isaka T, Yamazaki K, Onuki T. Surgery for non-small cell lung cancer in patients with a history of cardiovascular surgery. Surgery Today. 2017;47(3):284-92. DOI: 10.1007/s00595-016-1386-5.

Bawany FI, Khan MS, Khan A, Hussain M. Skeletonization techniques in coronary artery bypass graft surgery reduces the postoperative pain intensity and disability index. J Card Surg. 2014;29:47-50. DOI: 10.1111/jocs.12273.

Saggio G, Bianco A, Orengo G, Tancredi G, Del Gaudio C, Zeitani J. An Electronic-Engineered Sensory Sternal Retractor Aimed at Post-sternotomy Pain Reduction. In: Peixoto N, et al, editors. BIOSTEC 2017. Roma: Springer International Publishing AG; 2018. p. 3-18.

Sajja LR. Strategies to reduce deep sternal wound infection after bilateral internal mammary artery grafting. International Journal of Surgery. 2015;16:171-8. http://dx.doi.org/10.1016/j.ijsu.2014.11.017.

Ohira S, Miyata H, Yamazaki S, Numata S, Motomura N, Takamoto S, et al. Deep sternal wound infection after bilateral internal thoracic artery grafting: Insights from a Japanese national database. J Thorac Cardiovasc Surg. 2018 (In Press): Disponible en: https://doi.org/10.1016/j.jtcvs.2018.06.101.

Ding WJ, Ji Q, Shi YQ, Ma RH, Wang CS. Incidence of Deep Sternal Wound Infection in Diabetic Patients Undergoing Off-Pump Skeletonized Internal Thoracic Artery Grafting. Cardiology. 2016;133:111-8. DOI: 10.1159/000441137.

Wehman B, Taylor B. Coronary Revascularization Using Bilateral Internal Thoracic Arteries: Safe with Skeletonization? J Clin Exp Cardiolog. 2013;Suppl 7:007. DOI: 10.4172/2155-9880.S7-007.

Fu RH, Weinstein AL, Chang MM, Argenziano M, Ascherman JA, Rohde CH. Risk factors of infected sternal wounds versus sterile wound dehiscence. Journal of Surgical Research. 2016;200:400-7. http://dx.doi.org/10.1016/j.jss.2015.07.045.

Narayan P, Sarkar K, Trehan N, Chandra P, Chouhan NS, Puskas JD, et al. Key updates from international coronary congress 2016—a review. Indian Journal of Thoracic and Cardiovascular Surgery. 2018;34(1):44-52. DOI: 10.1007/s12055-017-0579-x.

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