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Xenical 120 mg acheter with 5 mL sterile saline was instilled (the same dose given to a patient prior surgery) and, once the first hour had passed, patient was intubated and intubation maintained with a central line placed in the chest or neck, if necessary. The patient was then transferred to the operating room. The patient was placed in a supine position. standard thoracostomy bag with 6 cm internal diameter tubing was attached to the aorta maintain cardiac perfusion. anesthesiologist had opened the bag a minimum of 10 min prior to each procedure. The anesthesiologist placed tube and stent within one 1-min increments. An intravenous line was kept in place throughout the entire time patient was under anesthesia. For these procedures, the patient's blood pressure was monitored throughout the entire procedure. patient's skin, blood pressure, body temperature, respiratory rate, and oral temperature were monitored. The patient underwent an additional cardiac checkup in the operating room 1 h after intubation. anesthesia, the patient was assessed for other conditions that needed attention and then allowed to sleep. The cardiac surgical team was comprised of 8: 3 cardiothoracic surgeons, 2 thoracic and an anesthesiologist. The surgeon in charge was only on duty during the procedure. surgical team followed standard operating procedures including preoperational procedures, pre-operation evaluation, surgical preparation, and in-situ procedures. Anesthetic preparation included the induction of anesthesia, administration local anesthetics, the insertion of intravenous lines, and the administration of local anesthetics, blood sampling, and measurements related to cardiac function. The surgeon and team members who performed the procedures were supervised by an in-depth anesthesiologist. After intubation, the patients were discharged in accordance with the standards used for discharge from a cardiovascular hospital. For most of the procedures, intubation procedure lasted 10 to 15 min. The first patient was intubated 4 min before the second patient and same time for the third and fourth patients [15]. The initial in-situ procedures were performed on a single patient. To prevent blood flow restrictions, the first patient had two tubes (Figure and ). The first tube was placed within one minute by a trained acheter xenical en pharmacie anesthetist after the patient was stabilized to allow for proper placement of the second tube. first intubation took place at the start of procedure and second was performed between 7 and 9 min. The second tube was placed immediately after the second intubation and first tubing was removed 15–30 min after the second tube was placed. For the first in-situ procedure, a standard thoracic scope was used to obtain a good visualization. The scope was placed through nasal opening and over the trachea to avoid causing any damage the superior vena cava. Afterward, after intubating the patient in operating room, scope was secured to a flexible backboard and placed into the chest cavity. A 3-cm-diameter suction tubing was placed along the top of thoracic cavity and a 2-cm-diameter plastic catheter was placed in the thoracic cavity by auscultatory technique (Figure ). The catheter was attached to a sterile plastic bag with long, flexible line that allowed a clear visualization of the trachea by placing a rubber mask over the nose and an eye mask over the eyes. surgeon kept two 5-mL syringes (1.5-ml or 2.0-ml) on their office counter, waiting to be used give the patient sedation as required. Figure shows the cardiac ultrasound measurements in right atrium and left ventricular cavity at 8 min after intubation. The measurements were not obtained during the final transection, which occurred.

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