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Difference between revisions of "Heart"
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→Heart dissection
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==Heart dissection== | ==Heart dissection== | ||
===Pericardium=== | |||
If adhesions are present decide whether they are: | |||
#Fibrinous (recent) ''or'', | |||
#Fibrous (old). | |||
===Identifying hardware=== | |||
*Defibrillator - thick wires. | |||
*Pacer - thin wires. | |||
===General rule=== | ===General rule=== | ||
*Open along the lines of flow. | *Open along the lines of flow. | ||
Note: | Note: | ||
* | *Do '''not''' open right atrium (RA) SVC to IVC. | ||
**Why? A.: You cut through the territory of the SA node. | |||
===Coronary arteries=== | |||
*These are often done first, i.e. before the heart is opened. | |||
*They should be sectioned at ~2 mm intervals. | |||
*A significant stenosis (defined by ''diameter'' narrowing) is 70-75%.<ref name=Ref_HospAuto147>{{Ref HospAuto|147}}</ref> | |||
Notes: | |||
*If calcified: | |||
**Dissect off the coronary tree + decal. | |||
===Right atrium=== | ===Right atrium=== | ||
*Open | *Open anteriorly ~ 1 cm above the tricuspid valve annulus. | ||
**Open right auricle at the same time. | **Open right auricle at the same time. | ||
===Examination of apex=== | |||
*Slice apex (perpendicular to the long axis of the heart), such that both ventricles can be seen. | |||
===Right ventricle=== | ===Right ventricle=== | ||
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===Left ventricular outflow tract=== | ===Left ventricular outflow tract=== | ||
* | *Open LVOT with cut(s) from LV; stay close to intraventricular septum.<ref>{{Ref HospAuto|</ref> | ||
**Avoid cutting the pulmonary artery. | **Avoid cutting the pulmonary artery. | ||
** | **With luck you end-up between the left coronary cusp and right coronary cusp. | ||
***Check whether the aortic valve and coronary ostia are normal. | |||
=== | ===Slicing=== | ||
After the heart is opened it should be sliced at 5-10 mm intervals to the semilunar valves. | |||
==Standard measures== | ==Standard measures== | ||