donnagullikson
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Pseudoaneurysm post trauma. The patient was brought to the operating room, placed supine on the operating table, and underwent general endotracheal anesthesia. He received antibiotics preoperatively. His right lower extremity was prepped and draped in the usual sterile fashion. The patient was identified and the procedure was verified. He had an arterial line and a Foley catheter placed. An incision was made over the pseudoaneurysm and the fascia was inicised. Previously placed femoral to above knee popliteal PTFE graft was identified and dissected free. The vein graft was posterior to this. Pseudoaneurysm was dissected free from surrounding tissue as was normal vein proximal and distal. The patient was heparinized. The pseudoaneurysm portion which appeared to measure approx 4 cm was resected. Spatulated anastomosis was then performed proximally and distally with 6-0 Prolened using an artergraft 5 mm. Appropriate flushing maneuvers were performed prior to completion of suture line. The patient has a great PT signal at completion. Protamine reversal of heparin was performed. The wound was irrigated with normal saline. The fasia was closed with 3-0 Vicryl. The subq tissue was closed with 3-0 Vicryl. The skin was closed with 4-0 Monocryl. The wound was dressed with Dermabond followed by Telfa, burn gauze and Medipore tape.
Thanks,
Pseudoaneurysm post trauma. The patient was brought to the operating room, placed supine on the operating table, and underwent general endotracheal anesthesia. He received antibiotics preoperatively. His right lower extremity was prepped and draped in the usual sterile fashion. The patient was identified and the procedure was verified. He had an arterial line and a Foley catheter placed. An incision was made over the pseudoaneurysm and the fascia was inicised. Previously placed femoral to above knee popliteal PTFE graft was identified and dissected free. The vein graft was posterior to this. Pseudoaneurysm was dissected free from surrounding tissue as was normal vein proximal and distal. The patient was heparinized. The pseudoaneurysm portion which appeared to measure approx 4 cm was resected. Spatulated anastomosis was then performed proximally and distally with 6-0 Prolened using an artergraft 5 mm. Appropriate flushing maneuvers were performed prior to completion of suture line. The patient has a great PT signal at completion. Protamine reversal of heparin was performed. The wound was irrigated with normal saline. The fasia was closed with 3-0 Vicryl. The subq tissue was closed with 3-0 Vicryl. The skin was closed with 4-0 Monocryl. The wound was dressed with Dermabond followed by Telfa, burn gauze and Medipore tape.
Thanks,