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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_4000_Библиотеки_им_академика_М_И_Перельмана
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Outlet line
Return limb clamped for
cardioplegia delivery
Return limb
Source limb
Source limb
Outlet line clamped
for recirculation
Figure 1.10 Recirculating cardioplegia system table lines. Top: Recirculating delivery system with table line return limb clamped for cardioplegia
delivery. Bottom: Recirculating delivery system with table line outlet limb clamped for recirculation.
G
F
H
D
D1
A1
G1
B1
C1
A
E1
F1
F (hidden)
C (hidden)
I
J
H
B
G
K
G1
M
L
A
A1
B1
C1
O
D
E
F1
D1
E1
N
B
C
E
Figure 1.13 Top and side views of a customized Stockert S5 heart–lung machine. A—Arterial head and its controller A1, B—cardioplegia head and its
controller B1, C—vent head and its controller C1, D—field sucker and its controller D1, E—field sucker and its controller E1, F—centrifugal head motor
(for kinetic venous‐assisted drainage) and its controller F1, G—electronic venous occluder and its controller G1, H—master display tower, I—sterile custom
tubing pack, J—custom cardioplegia tubing set, K—oxygenator, L—hemoconcentrator, M—blood gas sampling manifold, and N—ice bucket for cardioplegia
cooling coil.
AB C
Figure 1.14 Stockert heater‐cooler system 3 T (three‐tank system). A—Cold cardioplegia circuit. The first tank instantly provides 2–10 °C water to the
cardioplegia system. B—Warm cardioplegia circuit. The second tank instantly provides 15–41 °C water to the cardioplegia system. It can also be fitted for a
water‐based patient surface cooling/heating blanket. C—Oxygenator circuit. The third tank provides 15–41 °C water to the oxygenator heat exchanger. It
has a second pump and circuit to provide water flow from the same tank to a water‐based patient blanket if desired.
Esophagus
Trachea
Brachiocephalic artery
Superior vena cava
Right pulmonary arteries
Right pulmonary veins
Right atrium
Bronchi
Atrioventicular
(tricuspid) valve
Right ventricle
Inferior vena cava
Esophagus
Descending aorta
Septum
Left ventricle
Atrioventricular
(mitral) valve
Semilunar valves
Bronchi
Left atrium
Left pulmonary
veins
Left pulmonary
arteries
Aorta
Left subclavian
artery
Left common
carotid artery
Figure 1.15 General cardiac anatomy. http://en.wikipedia.org/wiki/File:Relations_of_the_aorta,_trachea,_esophagus_and_other_heart_structures.png.
via Wikipedia. Reproduced with permission from under the Creative Commons Attribution‐Share Alike 3.0. Unported license (accessed January 7, 2014).
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
Right common
carotid artery
Left common
carotid artery
Right subclavian
artery
Left subclavian
artery
Brachiocephalic
artery
Ascending aorta
Descending aorta
Aortic arch
Right coronary
artery
Left coronary
artery
Abdominal aorta
Thoracic aorta
Figure 1.16 Aortic arch anatomy. http://cnx.org/content/m46646/latest/2121_Aorta.jpg. Reproduced with permission from OpenStax College on
Wikimedia Commons under the Creative Commons Attribution‐Share Alike 3.0. Unported license (accessed January 7, 2014).
Right innominate
Left innominate
Internal jugular
External jugular
Subclavian
Highest left intercostal
Ligament of left vena cava
Oblique vein of left atrium
Coronary sinus
Accessory hemiazygos vein
Hemiazygos vein
Left suprarenal
Left renal
Left internal spermatic
Left common iliac
External iliac
Hypogastric
Superior vena cava
Azygos vein
Prerenal part of
inferior vena cava
Figure 1.17 Central venous anatomy. Reproduced with permission from Gray’s Anatomy of the Human Body, 1918 edition (http://en.wikipedia.org/
wiki/File:Gray480.png) via Wikipedia.
AB CD EF
Figure 1.18 Select pediatric venous cannulae. A—14 Fr. Terumo Tenderflow right angle PVC tip. B—14 Fr. Medtronic DLP right angle metal tip. C—12 Fr.
Medtronic DLP right angle PVC tip. D—12 Fr. Edwards Lifesciences Thin‐Flex right angle plastic tip. E—14 Fr. Medtronic Bio‐Medicus straight with
multiple side port holes. F—14 Fr. Medtronic DLP malleable straight PVC tip.
AB
CD
Figure 1.19 Select arterial cannulae for central cannulation. A‐6 Fr. Medtronic DLP One Piece. B‐12 Fr. Medtronic Bio‐Medicus. C‐20 Fr. Medtronic EOPA.
D‐22 Fr. Medtronic EOPA CAP.
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
AB
C
Figure 1.20 Luminal variation between types of arterial cannulae. A‐Standard round lumen for a 22 Fr. Medtronic arterial cannula. B‐D‐shaped lumen
for a 22 Fr. Medtronic arterial cannula with central aortic pressure (CAP) monitoring capability. C‐Left of “C” is the central aortic pressure monitoring port.
Surface contact
Intrinsic
XII
XI
IX
X
X
XIII
XIII
a
TF:VII
a
Tissue damage
Prothrombin
Thrombin
(serine protease)
Fibrinogen Fibrin
Stable brin
clot
Common
Extrinsic
(VIII, PL, Ca
++
)
(V, PL, Ca
++
)
XII
a
XI
a
IX
a
X
a
Figure 3.1 Classical description of the blood coagulation pathways. VII-stabile factor, XII-Hageman factor, IX-Christmas factor, XI-plasma
thromboplastin, XIII-fibrin stabilizing factor, Ca++ ionized calcium, PL-platelets, TF-tissue factor. http://commons.wikimedia.org/wiki/
File:Classical_blood_coagulation_pathway.png. Reproduced with permission from Graham Beards and Wikimedia Commons.
Platelets
Tissue factor
VII
IX
IX
a
XIa XI
VIII
a
XIIIa
XIII
X
a
X
Prothrombin
Fibrin
Stabilised,
cross-linked
brin clot
Thrombin
Fibrinogen
Propagation
phase
V
a
V
VIII
VII
a
Activated platelets
Initiation phase
Blood coagulation in vivo
Amplication phase
Figure 3.2 Cell-based model of hemostasis in vivo. http://commons.wikimedia.org/wiki/File:Coagulation_in_vivo.png. Reproduced with permission
from Graham Beards and Wikimedia Commons.
WILEY END USER LICENSE AGREEMENT
Go to www.wiley.com/go/eula to access Wiley’s ebook EULA.
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
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