Off-pump waffle procedure using an ultrasonic scalpel for XXXX

@entity1 @entity3822 @entity15496
UNASSIGNED: Radical pericardiectomy alone is not effective in @entity1 with @entity3822 accompanied by @entity15496 . However, a waffle procedure is very effective in these @entity1 , as we demonstrate in this paper. Firstly, we performed a radical pericardiectomy via a median sternotomy. We used an ultrasonic scalpel for this procedure, and an apical suction device was useful for lifting the heart. This technique is similar to that used in off-pump coronary artery bypass grafting. After the whole heart was dissected from the markedly thickened parietal pericardium, a waffle procedure was performed on the left ventricle first. Multiple longitudinal and transverse incisions were made on the thickened epicardium using an ultrasonic scalpel. After the left ventricle was fully relieved of constriction, the same procedure was performed on the right ventricle. Thereafter, a remarkable improvement of our @entity1 's haemodynamic status was obtained. The whole procedure can be done without cardiopulmonary bypass. We describe tips for performing the waffle procedure without cardiopulmonary bypass using an ultrasonic scalpel and apical suction device, as well as pitfalls to avoid.
