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A Trick to Control the Bleeding in Cardiovascular Surgery.

Byline: Yi-Ming. Ni, Bold. Altangerel, Hong-Fei. Xu, Hai-Ge. Zhao

When accidental bleeding happens on the posterior wall of vena cava during the procedure of vena cava cannulation [Figure 1]a, two pieces of thymus gland tissue around 2 cm x 1 cm were taken as the mattress tips, and these two pieces of tissue were put aside the bottom of vena cava, then use Prolene (Ethicon, Somerville, NJ, USA) to pass through the interspace under the posterior wall to make a mattress suture [Figure 1]b and c. Knot is tied with adequate tension to eliminate any obvious bleeding and to achieve complete hemostasis [Figure 1]d. In some cases, additional mattress sutures are needed to stop bleeding.{Figure 1}

This technique has now been tested effectively in three patients with the bleeding of posterior wall of vena cava without exposing the posterior wall. And more importantly, if this method failed to control the bleeding, the thymus gland tissues can be removed by cutting off the suture without doing any damage to the vessels. We believe the new technique described here is safe, effective, lower risk of infection (compared to artificial felt), and especially useful when the bleeding occurs after the cardiopulmonary bypass has been dismantled.

Acknowledgments

Ye-Qing Mao (Zhejiang University) is appreciated for drawing the topography.

References

1. Zenz T, Mertens D, Dohner H, Stilgenbauer S. Molecular diagnostics in chronic lymphocytic leukemia-pathogenetic and clinical implications. Leuk Lymphoma 2008;49:864-73.

2. Pfeifer D, Pantic M, Skatulla I, Rawluk J, Kreutz C, Martens UM, et al. Genome-wide analysis of DNA copy number changes and LOH in CLL using high-density SNP arrays. Blood 2007;109:1202-10.

3. Lai YY, Huang XJ. Cytogenetic characteristics of B cell chronic lymphocytic leukemia in 275 Chinese patients by fluorescence in situ hybridization: A multicenter study. Chin Med J 2011;124:2417-22.

4. Hallek M, Fischer K, Fingerle-Rowson G, Fink AM, Busch R, Mayer J, et al. Addition of rituximab to fludarabine and cyclophosphamide in patients with chronic lymphocytic leukaemia: A randomised, open-label, phase 3 trial. Lancet 2010;376:1164-74.

5. Mosca L, Fabris S, Lionetti M, Todoerti K, Agnelli L, Morabito F, et al. Integrative genomics analyses reveal molecularly distinct subgroups of B-cell chronic lymphocytic leukemia patients with 13q14 deletion. Clin Cancer Res 2010;16:5641-53.

6. Cosson A, Chapiro E, Belhouachi N, Cung HA, Keren B, Damm F, et al. 14q deletions are associated with trisomy 12, NOTCH1 mutations and unmutated IGHV genes in chronic lymphocytic leukemia and small lymphocytic lymphoma. Genes Chromosomes Cancer 2014;53:657-66.

7. Brown JR, Hanna M, Tesar B, Werner L, Pochet N, Asara JM, et al. Integrative genomic analysis implicates gain of PIK3CA at 3q26 and MYC at 8q24 in chronic lymphocytic leukemia. Clin Cancer Res 2012;18:3791-802.

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Title Annotation:Clinical Practice
Author:Ni, Yi-Ming; Altangerel, Bold; Xu, Hong-Fei; Zhao, Hai-Ge
Publication:Chinese Medical Journal
Article Type:Report
Date:Jul 1, 2015
Words:461
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