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A D V E R T I S E M E N T
A D V E R T I S E M E N T
The patient was returned to the operating room five weeks after her Bentall procedure for replacement of the descending thoracic aneurysm. The modified right lateral decubitus position is shown with the chest supported at a 45° angle and the hips rotated posteriorly for access to the left groin. A lumbar cerebrospinal fluid (CSF) drain was placed to reduce CSF pressure below 10 mm Hg and optimize spinal cord blood flow during the procedure. Arterial pressure was monitored to reduce mean arterial pressure to 80 mm Hg during cross clamping and avoid upper body hypertension that could lead to stroke.
A D V E R T I S E M E N T
The left femoral vessels were isolated at the same time the left thoracotomy was begun (view from patient’s foot).
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A left posterolateral thoracotomy (see right upper lobectomy) was made in the fourth interspace, and adhesions from the prior Bentall procedure were lysed.
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This page was last modified on 12/17/2002.
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