**26. References**


It is the opinion of the authors that the above average results in morbidity and mortality for our cardiac patients may partly be due to the aggressive use of IAB in cardiac procedures. Aggressive use of counterpulsation therapy preempts infarction for the cardiac patient and

I would like to thank Maquet cardiovascular LLC (formerly Datascope) for providing most of the figures and pictures from their educational archives. I would also like to thank

Abid Q,et al.(2001).Use of Intraaortic balloon pump in left ventricular rupture after mitral valve replacement.*Annals of thoracic surgery*.74(6),(dec 2002),2194-5,12643426. Alderman JD,Gabliani GI,McCabe CH et al.(1987). Incidence and management of limb

Barron HV,et al. (2001). The use of Intra-aortic balloon counterpulsation in patients with

Christenson JT,Simonet F,Badel P,et al.(1999).Optimal timing of Intra-aortic balloon pump

68,issue:3,(nov 1999),934-939, 1097-1103, doi:10.1016/S0003-4975(99)00687-6. Conolly HM,Koh j.(2012) Echocardiography,In: Braunwalds heart disease,atext book of

Datt B, Hutchison L, Peniston C. *(2007).* Trans-Aortic Counterpulsation:A viable alternative? *Journal of extracorporeal technology.(*jun *2007);*vol 39,issue:2,91-95. PMID17672190. Dietl CA,et al.(1996).Efficacy and cost effectiveness of pre-operative IABP in patients with

Funk M,Gleason J,Foel D.(1989). Lower limb ischemia related to use of the intraaortic

Goldberger M,Tabak SW,Shah PK.(1986).Clinical experience with intraaortic balloon pump

Gottlieb SO,Brinker JA,Borkon AM., et al.(1984*).* Identification of patients at high risk for

balloon pump.*Heart lung*.18(6),(Nov 1989),542-552,PMID 2584053

111,issue:3,(march 1986),497-502,doi:10.1016/0002-8703(86)90054-2.

276,Saunders Elsevier,ISBN 978-0-8089-2436-4,Philadelphia,PA,USA Curtis JJ,Boland M,Bliss D et al.(1988). Intra-aortic balloon cardiac assist: complication rates

ischemia with percutaneous wire-guided intraaortic balloon catheters.*Journal of the American college of Cardiology*.Vol 9,issue:3,(mar 1987),524-530, doi:10.1016/S0735-

cardiogenic shock complicating acute myocardial infarction:Data from the national registry of myocardial infarction 2.*American Heart Journal*,141(6),(jun 2001),889-

support in high risk coronary patients.*The annals of thoracic surgery*.vol

cardiovascular medicine,2012,Bonozo R,Mann DL,Zipes DP,Libby P,200-

for the surgical and percutaneous insertion techniques.*American Surgery*.(mar

ejection fraction of 0.25 or less. *The annals of thoracic surgery*, vol: 62, issue: 2, (aug

counterpulsation in 112 consecutive patients.*American Heart journal*. Vol

complications of intraaortic balloon counterpulsation: A multivariate risk factor analysis.*TheAmerican journal of cardiology*.Vol 53,Issue:8,(Apr 1984),1135-1139,

Maquet International who funded the editing costs of printing this chapter.

in turn improves outcomes in cardiac surgery.

**25. Acknowledgement** 

1097(87)80044-X .

892,11376306.

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1996), 401-409, ISSN 00034975.

doi:10.1016/0002-9149(84)90650-7.

**26. References** 


**3** 

*Germany* 

**The Hybrid Operating Room** 

Georg Nollert, Thomas Hartkens, Anne Figel,

*Siemens AG Healthcare Sector, Forchheim* 

Clemens Bulitta, Franziska Altenbeck and Vanessa Gerhard

The integration of interventional and surgical techniques is demanding a new working environment for an interdisciplinary cardiovascular team: the hybrid operating room, where angiographic imaging capabilities are integrated in an operating suite. A deep understanding of the clinical applications, the current and future technology, and their

The definition of hybrid procedures in the literature varies widely. A strict definition of a hybrid procedure is a major procedure that combines a conventional surgical part including a skin incision with an interventional part using some sort of catheter-based procedure guided by fluoroscopic or MRI imaging in a hybrid room without interruption. Wider definitions include procedures where the interventional and surgical parts are done in sequence, where a surgical part is only necessary in case of emergency or even minor procedures as venous cut downs. Sometimes, fluoroscopy guided interventions performed by surgeons (e.g. endovascular aortic repair in aortic abdominal aneurysms) are referred to as hybrid procedures. The term hybrid procedure in the radiology world may also refer to the combination of two imaging modalities for diagnostics or therapeutic purposes. In this chapter, the strict definition of hybrid procedures is applied and only procedures with fluoroscopic imaging are included, as interventional MRI still is in its very early stage.

Although surgery remains the treatment of choice for most congenital cardiac malformations, interventional cardiology approaches are increasingly being used in simple and even complex lesions. The percutaneous approach can be challenging due to low patient weight or poor vascular access, induced rhythm disturbances and hemodynamic compromise (Bacha et al., 2007). Difficult and complex anatomy as in double-outlet right ventricle or transposition of the great arteries, or acute turns or kinks in the pulmonary arteries of tetralogy of Fallot patients can make percutaneous procedures challenging if not impossible (Sivakumar et al., 2007). However, surgery also has its limitations. Examples are operative closure of multiple apical muscular ventricular septal defects, adequate and

implications on workflows is needed for a sound room design.

**2. Clinical applications in cardiovascular therapy** 

**2.1 Definition of hybrid procedures** 

**2.2 Pediatric cardiac surgery** 

**1. Introduction** 

