Preoperative computed tomography in the planning of median resternotomy in children

The capabilities of computed tomography (CT) in the diagnosis mediastinal adhesions and measuring density when planning midline resternotomy children were assessed, effect preoperative CT on incidence surgical complications was studied. According to several authors, frequency resternotomies cardiac surgery is up 20% total number surgeries per year accompanied by significant difficulties isolation heart vessels. In pediatric surgery, complex congenital disease (CHD) mostly requires a staged approach. staging CHD correction need for repeated most defects make problem safe access urgent. Postoperative are one acute problems modern surgery. formation an inevitable reaction body after primary Massive that develop commonly lead adhesion major great vessels posterior surface sternum. These changes especially pronounced due high reactivity lack technical possibility expediency pericardial suturing Rough during complicate surgeons task increase risk complications. main dangers damage various structures thorax such as right left heart, aorta, coronary arteries, pulmonary artery, brachiocephalic vein. postoperative mediastinum before difficult. has widest diagnostic assessing adhesions. When performing part planning, it important examine topography, assess degree adjacency pericardium structures, determine presence adhesions, patency diameter select cannulas cannulation methods necessary emergency start cardiopulmonary bypass (CPB) trauma. criteria reduce risks traumatization allow tactics timely preventive measures. Depending density, extent, localization cardiolysis technique required initiation CPB may be changed. use allows predict visualize adhesive bands measure their which helps surgeon adjust regarding method volume arteries veins, thus determining cannula advance if urgent needed. Therefore, standardization description protocols with assessment key further development.