The Blower: A Useful Tool to Complete Thrombectomy of the Mechanical Prosthetic Valve

Aroussi, Aziz Alami; Sami, Ibrahim Mohamed; Leguerrier, Alain; Verhoye, Jean Phillippe

doi:10.1016/j.athoracsur.2005.02.070

Cited by 14 publications

(8 citation statements)

References 4 publications

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“…The water jet instrument possesses several qualities concerning dissection that are superior to those of conventional instruments, such as selective tissue removal with vessel preservation, based on the different tensile strengths of tissues. Pressure‐driven continuous water jet technology was initially used in the liver in the 1980s and thereafter it has been used in neurosurgery, stomach, colon, cardiovascular, and ophthalmological surgery. The use of this system in liver surgery results in reduced blood loss and less parenchymal trauma than ultrasonic aspiration or blunt dissection .…”

Section: Discussionmentioning

confidence: 99%

Experimental application of pulsed laser‐induced water jet for endoscopic submucosal dissection: Mechanical investigation and preliminary experiment in swine

Sato

Nakano

Nakagawa

et al. 2012

Digestive Endoscopy

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Section: Discussionmentioning

confidence: 99%

Experimental application of pulsed laser‐induced water jet for endoscopic submucosal dissection: Mechanical investigation and preliminary experiment in swine

Sato

Nakano

Nakagawa

et al. 2012

Digestive Endoscopy

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“…Thrombolysis, thrombectomy or prosthetic replacement is current available treatment options for prosthetic valve thrombosis [12]. Low-output states, cardiogenic shock, as well as absolute contraindications limit thrombolysis usage [13].…”

Section: Discussionmentioning

confidence: 99%

Surgical Outcome of Prosthetic Heart Valve Obstruction: Single Center Experience

Brik¹,

Salem²,

Talat³

et al. 2012

WJCS

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Objective: Valve thrombosis defined as any thrombus not caused by infection attached to or near an operated valve that occludes part of the blood flow path and interferes with valve function. Treatment modalities are thrombolytic therapy, surgical thrombectomy and debridement, or re-replacement. The aim of this study is to review our experience in surgical thrombectomy and debridement for obstructed mechanical valve prosthesis, and the impact of the procedure on the outcome in comparison to re-replacement; Methods: The study was conducted retrospectively between 1995 to 2012 in Department of Cardiothoracic surgery, cardiology and internal medicine, Zagazig University Hospital. 92 patients with stuck valve were divided into two groups. Group (A): 54 patients with re replacement and Group (B): 38 patients treated by thrombectomy and debridement; Results: 92 patients with stuck valves the mean age was 38.4(±9.2), 68 male and 85 female in both groups. The large numbers of cases were mitral valve 35 (64.8%) patients in group A and 22 (57.9%) patients in group B, aortic malfunction in group A was 11 (20.4%)patients and 9 (23.7%) cases in group B, double valve malfunction was rare represent 8 (14.8%) and 7 (18.4%)cases in group A and group B respectively; Conclusion: We conclude that thrombectomy and debridement for malfunctioning mechanical valve is a safe, easy and rapid procedure to perform in some cases to avoid the risk of re replacement

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“…The water jet technology with a continuous pressure-driven water flow was initially used in liver surgery in the 1980s [13], and, thereafter, in neurosurgery [19], and stomach [20], colon [21], cardiovascular [22] and ophthalmological [23] surgeries. It might be beneficial in that the water jet, as a no-touch technique, is less traumatic to the vascular structures than the directly applied ultrasonic aspirator tip [24].…”

Section: Discussionmentioning

confidence: 99%

The Dissection Profile and Mechanism of Tissue-Selective Dissection of the Piezo Actuator-Driven Pulsed Water Jet as a Surgical Instrument: Laboratory Investigation Using Swine Liver

et al. 2014

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Background/Purpose: The water jet technique dissects tissue while sparing cord-like structures such as blood vessels. The mechanism of such tissue-selective dissection has been unknown. The novel piezo actuator-driven pulsed water jet (ADPJ) system can achieve dissection with remarkably reduced water consumption compared to the conventional water jet; however, the system's characteristics and dissection capabilities on any organ have not been clarified. The purposes of this study were to characterize the physical properties of the novel ADPJ system, evaluate the dissection ability in swine organs, and reveal the mechanism of tissue-selective dissection. Methods: The pulsed water jet system comprised a pump chamber driven by a piezo actuator, a stainless steel tube, and a nozzle. The peak pressure of the pulsed water jet was measured through a sensing hole using a pressure sensor. The pulsed water jet technique was applied on swine liver in order to dissect tissue on a moving table using one-way linear ejection at a constant speed. The dissection depth was measured with light microscopy and evaluated histologically. The physical properties of swine liver were evaluated by breaking strength tests using tabletop universal testing instruments. The liver parenchyma was also cut with three currently available surgical devices to compare the histological findings. Results: The peak pressure of the pulsed water jet positively correlated with the input voltage (R² = 0.9982, p < 0.0001), and this was reflected in the dissection depth. The dissection depth negatively correlated with the breaking strength of the liver parenchyma (R² = 0.6694, p < 0.0001). The average breaking strengths of the liver parenchyma, hepatic veins, and Glisson's sheaths were 1.41 ± 0.45, 8.66 ± 1.70, and 29.6 ± 11.0 MPa, respectively. The breaking strength of the liver parenchyma was significantly lower than that of the hepatic veins and Glisson's sheaths. Histological staining confirmed that the liver parenchyma was selectively dissected, preserving the hepatic veins and Glisson's sheaths in contrast to what is commonly observed with electrocautery or ultrasonic instruments. Conclusions: The dissection depth of liver tissue is well controlled by input voltage and is influenced by the moving velocity and the physical properties of the organ. We showed that the device can be used to assure liver resection with tissue selectivity due to tissue-specific physical properties. Although this study uses an excised organ, further in vivo studies are necessary. The present work demonstrates that this device may function as an alternative tool for surgery due to its good controllability of the dissection depth and ability of tissue selectivity.

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The Blower: A Useful Tool to Complete Thrombectomy of the Mechanical Prosthetic Valve

Cited by 14 publications

References 4 publications

Experimental application of pulsed laser‐induced water jet for endoscopic submucosal dissection: Mechanical investigation and preliminary experiment in swine

Experimental application of pulsed laser‐induced water jet for endoscopic submucosal dissection: Mechanical investigation and preliminary experiment in swine

Surgical Outcome of Prosthetic Heart Valve Obstruction: Single Center Experience

The Dissection Profile and Mechanism of Tissue-Selective Dissection of the Piezo Actuator-Driven Pulsed Water Jet as a Surgical Instrument: Laboratory Investigation Using Swine Liver

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