Getinge MAQUET HEARTSTRING III Instrucciones De Uso página 8

HEARTSTRING III Proximal Seal System
9.4 To begin HEARTSTRING III Proximal Seal removal, use a thumb and forefinger to provide support
for the suture line of the anastomosis and the surrounding tissue. Light downward pressure with the
thumb and forefinger will facilitate the HEARTSTRING III Proximal Seal removal.
9.5 Hold the Seal Stem right below the Anchor Tab and gently pull the Seal Stem to unravel and remove
the HEARTSTRING III Proximal Seal (Figure 20). Continuously monitor the resistance felt while
removing the HEARTSTRING III Proximal Seal.
WARNING: Do not pull the Anchor Tab to unravel the HEARTSTRING III Proximal Seal.
9.6 If an abrupt and SUBSTANTIAL RESISTANCE to unraveling is felt before the HEARTSTRING III
Proximal Seal is completely removed, immediately discontinue pulling the Seal Stem, and go to
step 9.6.1.
If ADDITIONAL RESISTANCE IS NOT felt during HEARTSTRING III Proximal Seal removal, go
to step 9.7 and complete Seal removal per IFU.
9.6.1 Gently place index finger of one hand over the aorta-graft junction, and apply light pressure to control
bleeding.
9.6.2 Extract the remainder of the HEARTSTRING III Proximal Seal through anastomosis by pulling the
Seal Stem with other hand (as in Step 9.5.) Adjust pressure from index finger to minimize resistance
to the HEARTSTRING III Proximal Seal as it is removed from the temporary gap at the graft to aorta
interface (Figure 21).
WARNING: If the Seal Stem continues to feel tight during HEARTSTRING III Proximal Seal
extraction, or atraumatic Seal extraction is unsuccessful, do not continue to pull on the Seal Stem.
Apply a partial occlusion clamp, undo the anastomosis, remove the HEARTSTRING III Proximal
Seal, and complete the anastomosis using an aortic partial occlusion clamp.
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Figure 19.
Secured Seal Stem, Cut end of Tether
Figure 20.
Removal of the HEARTSTRING III Proximal Seal
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