Ultrasonic Devices in Cardiac Surgery

Ghosh, Piyali

doi:10.1177/021849239900700422

Cited by 7 publications

(5 citation statements)

References 42 publications

(69 reference statements)

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“…Ultrasonic energy causes atomization of fluid, which may create a transient mist. However, overall dissection time may be shorter with ultrasonic cavitation aspirators (UCA) or ultrasonic-activated scalpels after the initial learning curve [36]. It has been shown in many studies that the ultrasonic devices are not as efficient in sealing medium to large sized blood vessels [26, 37, 38].…”

Section: Methodsmentioning

confidence: 99%

Common uses and cited complications of energy in surgery

et al. 2013

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Background Instruments that apply energy to cut, coagulate and dissect tissue with minimal bleeding facilitate surgery. The improper use of energy devices may increase patient morbidity and mortality. The current article reviews various energy sources in terms of their common uses and safe practices. Methods For the purpose of this review, a general search was conducted through NCBI, SpringerLink and Google. Articles describing laparoscopic or minimally invasive surgeries using a single or multiple energy sources are considered, as are the articles comparing various commercial energy devices in laboratory settings. Keywords such as ‘laparoscopy’, ‘energy’, ‘laser’, ‘electrosurgery’, ‘monopolar’, ‘bipolar’, ‘harmonic’, ‘ultrasonic’, ‘cryosurgery’, ‘argon beam’, ‘laser’, ‘complications’, and ‘death’ were used in the search. Results and Conclusion A review of the literature shows that the performance of the energy devices depends upon the type of procedure. There is no consensus as to which device is optimal for a given procedure. The technical skill level of the surgeon and the knowledge about the devices are both important factors in deciding safe outcomes. As new energy devices enter the market increases, surgeons should be aware of their indicated use in laparoscopic, endoscopic and open surgery.

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Section: Methodsmentioning

confidence: 99%

Common uses and cited complications of energy in surgery

et al. 2013

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“…13 CUSA technique employs ultrasonic waves to disintegrate calcium and the resulting debris can be extracted without causing damage to adjacent structures. 21,22,23 In conclusion, CCMA are entities that are rare and underrecognized variants of MAC, which need to be distinguished from common differentials such as intra-cardiac tumors, myocardial abscesses, thrombus 9 or cyst. 20…”

Section: Discussionmentioning

confidence: 99%

Left Atrial Pseudotumor Caused By Caseous Calcification of the Mitral Annulus, Case Report with Review of Literature

Gill¹,

Chen²

2011

N A J Med Sci

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Caseous calcification of the mitral annulus (CCMA) is a rare form of periannular calcification, occurring in 0.06% of all echocardiographic studies and in 0.63% of all patients with mitral annular calcification. Here, we report a case of CCMA manifesting as a left atrial mass. The patient is a 78-year-old African American female with multiple co-morbidities, who presented with symptomatic coronary artery disease and chest pain. A pre-operative echocardiogram revealed a mass in the posterior wall of the left atrium, which did not appear to affect the mitral valve or protrude into the left atrial chamber. Intra-operatively, white toothpaste-like material was removed from the mass lesion. Gross examination revealed multiple fragments of grey-white friable caseous material, measuring 3 x 2.5 x 1 cm in aggregate. Bacterial and fungal cultures from this material were both negative. Microscopic examination showed this material to be amorphous, non-viable, basophilic, and acellular, with foci of calcification. These morphological features were diagnostic for CCMA. Review of the literature indicated that CCMA is a very rare benign lesion, presenting as a round, tumor-like mass with central echolucencies on echocardiography. We believe our case report will further raise the awareness of CCMA so that pathologists and radiologists can get familiar with this rare disease to avoid potential misdiagnosis.

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“…These ceramic elements expand and contract on electrical activation at a frequency of 55.5 kHz generating longitudinal motion that is transmitted via the acoustic motion and blade to deliver maximum harmonic motion at the tip of the instrument. The mechanical motion of the blade in turn causes collagen molecules within tissues to vibrate and become denatured forming a coagulum, thereby securing hemostasis 9 . Advantages of the HS are that it operates at a distance of 85 μm and the electric current does not pass through the patient and hence there is no interference with the pacemaker function.…”

Section: Discussionmentioning

confidence: 99%

“…The mechanical motion of the blade in turn causes collagen molecules within tissues to vibrate and become denatured forming a coagulum, thereby securing hemostasis. 9 Advantages of the HS are that it operates at a distance of 85 μm and the electric current does not pass through the patient and hence there is no interference with the pacemaker function. There is less than 1 • C rise of temperature at 0.5 cm from the point of contact and macroscopic lateral tissue damage extends to only 1 mm and microscopic tissue damage extends to only 3 mm from the point of contact.…”

Section: Discussionmentioning

confidence: 99%