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To prepare for ventriculotomy first place the patient in steep trendelenburg position.
Then elevate the A-packs of the heart with laps and locate the dimple of the left ventricular
A-packs as an anatomic landmark prior to coring. The coring location should be slightly interior
to the A-packs, a few cm lateral to the left interior descending coronary artery. (Anterior)
-Choosing a location is important so we identify left interior descending coronary artery here.
So septum is right about here. So we wanna keep our core close to the septum. If it's
may too lateral then you orienting ,..............into the LVA septum.
First, cut the ligature securing the coring knife. Remove the plastic plugs from each
end and place the handle through the hole in a knife cylinder to make a tea-handle.
-coring knife pls. I prolong stich there to keep some tracktion on a ... tip.
Align an orientation of the coring knife toward micro valve taking care to avoid orienting
the inlet towards the inner ventricular septum. Device function will be compromised in a presence
of the inlet abstraction. CAUTION: Do not allow the knife to involve
the ventricular septum while performing LV coring.
Apply the coring edge to the epicarduim and maintain pressure while rotating the knife
until the ventricular cavady is ...red. - I finish the core... now. I always have
to make sure that is no... here. Remove the core and WARNING: Inspect the ventricle
and remove any mural thrombi or trabecula that may impede flow.
- Take control .. some epicardium is here ... trabecula here .. try to remove.. carefull .. fragments of muscle
... pump function. Pretty happy ... opening