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Eric L. R. Bédard
Yves Leclerc
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J Thorac Cardiovasc Surg 2004;127:280-281
© 2004 The American Association for Thoracic Surgery

Brief communication

Maintenance of hemodynamic stability during pericardiectomy with the Starfish 2 Heart Positioner

Eric L. R. Bédard, MD, MSc, FRCS(C)a, Yves Leclerc, MD, FRCS(C)a,*

a Division of Cardiovascular and Thoracic Surgery, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada

Received for publication July 18, 2003; accepted for publication September 16, 2003.

* Address for correspondence: Yves Leclerc, MD, FRCS(C), St Michael's Hospital, 30 Bond St, Toronto, Ontario M5B 1W8, Canada
leclercy@rogers.com

The first 20% of the full text of this article appears below.

Pericardiectomy for chronic pericarditis can be a technically difficult procedure associated with high mortality.1 The use of cardiopulmonary bypass (CPB), although necessary on occasion, can be associated with significant bleeding, leading many surgeons to prefer its avoidance. Technologic advances in heart positioning devices have enabled the widespread application of beating-heart coronary revascularization. In this report we describe our use of the Starfish 2 Heart Positioner (Medtronic, Inc, Minneapolis, Minn) in the treatment of chronic pericarditis.

Clinical summaries

Patient 1
A 41-year-old Iranian war veteran had a several-week history of progressive shortness of breath, increasing abdominal girth, and peripheral edema. Echocardiography and computed tomography confirmed the diagnosis of severe constrictive pericarditis. Subsequent cardiac catheterization demonstrated the typical dip and plateau pattern. At the operation, the heart was approached through a median sternotomy with a Cell Saver system (Haemonetics Corporation, Braintree Mass) available and CPB on standby. The thickened (7 mm), calcified parietal pericardium was resected laterally toward each phrenic nerve. Once the . . . [Full Text of this Article]






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