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Ann Thorac Surg 2005;80:1567
© 2005 The Society of Thoracic Surgeons

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Correspondence

A Simple Device for Visualization in Off-Pump Coronary Artery Bypass Surgery

Federal University of São Paulo, Cardiovascular Surgery Discipline, Rua Botucatu, 740, São Paul, 04023-900 Brazil

(Email: wjgomes.dcir{at}epm.br).

To the Editor:

The letter from Brown and colleagues [1] drew our attention by the fact that recently repeated articles have been reporting complications associated to CO₂ blower usage in on-pump and off-pump coronary artery bypass surgery [2, 3].

Despite the fact that CO₂ blowers can improve visualization of coronary arteries during the anastomosis construction, it is now clear that it is not totally safe.

Our view is that the CO₂ blower is unnecessary. For the last 23 years [4], we have been using a simple and efficient device to facilitate coronary anastomosis in off-pump surgery.

The device consists of a 20-mL syringe coupled to a 22 gauge ¹/₄ needle having the tip broken off. Filled with saline and gently flushed (by assistant or scrub nurse) only during the brief periods of passing the stitches, the field is kept clear at that time (Fig 1).

View larger version (56K): [in this window] [in a new window]   Fig 1. The 20-mL syringe with the tipless needle flushing the saline content.

By sharing our experience, we hope we have contributed to make the anastomosis during off-pump coronary artery bypass surgery easier and safer.

	References

Top References

 

1. Brown KM, Sabetai MM, Venn GE. Gas embolization from the left ventricle and aortic roota possible side effect of high-flow gas insufflation during coronary artery surgery. Ann Thorac Surg 2004;78:387-388.[Free Full Text]
2. Mair H, Sergeant P. Air embolism caused by blower mister J Thorac Cardiovasc Surg 2004;127:897.[Free Full Text]
3. Nollert G, Oberhoffer M, Reichart B, Vicol C. Combination of the HEARTSTRING proximal seal system with a blower mistera possible source of gas emboli. J Thorac Cardiovasc Surg 2003;126:1192-1194.[Free Full Text]
4. Buffolo E, de Andrade JCS, Branco JN, Teles CA, Aguiar LF, Gomes WJ. Coronary artery bypass grafting without cardiopulmonary bypass Ann Thorac Surg 1996;61:63-66.[Abstract/Free Full Text]

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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Walter J. Gomes Enio Buffolo Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gomes, W. J. Articles by Buffolo, E. Search for Related Content PubMed PubMed Citation Articles by Gomes, W. J. Articles by Buffolo, E.