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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.


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


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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
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