scholarly journals Open Seldinger-guided peripheral femoro-femoral cannulation technique for totally endoscopic cardiac surgery

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yi Chen ◽  
Liang-wan Chen ◽  
Xiao-fu Dai ◽  
Xue-shan Huang
Keyword(s):  
Cardiac Surgery ◽  
Septal Defect ◽  
Femoral Vein ◽  
Direct Vision ◽  
Limb Ischaemia ◽  
Femoral Vessel ◽  
Purse String ◽  
Artery Cannulation ◽  
Hospital Survival ◽  
Cannulation Technique

Abstract Background The cannulation technique used in totally endoscopic cardiac surgery has a significant impact on the overall prognosis of patients. However, there are no large cohort studies to discuss it. Here we report on our research of using open Seldinger-guided technique to establish femoro-femoral cardiopulmonary bypass during totally endoscopic cardiac surgery and evaluate its safety and efficacy. Methods The institutional database from 2017 to 2020 was retrospectively reviewed to find cases in which totally endoscopic cardiac surgery was performed. We identified 214 consecutive patients who underwent totally endoscopic cardiac surgery with peripheral femoro-femoral cannulation. All patients underwent femoral artery cannulation. Of these, 201 were cannulated in the femoral vein and 13 were cannulated in the femoral vein combined with internal jugular cannulation. The technique involves surgically exposing the femoral vessel, setting up purse-string over the vessels and then inserting a guidewire into the femoral vessel without a vascular incision, followed by exchange of the guidewire with a cannula. Results Surgery indications included mitral valve disease in 82.71% (177/214), atrial septal defect in 11.68% (25/214) and tricuspid regurgitation in the remaining 5.61% (12/214). Hospital survival was 98.60% (211/214). There were no cases of stroke and postoperative limb ischaemia. No femoral vessel injuries or wound infections was observed. No late pseudoaneurysms were evident. Conclusion The open Seldinger-guided femoro-femoral cannulation technique is effective and safe. We highly recommend this technique, given its safety, simplicity and speed under direct vision. The limited manipulation of the vessels under direct vision minimizes the risk of local complications.

scholarly journals Peripheral vascular complications following totally endoscopic cardiac surgery

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ling-chen Huang ◽  
Qi-chen Xu ◽  
Dao-zhong Chen ◽  
Xiao-fu Dai ◽  
Liang-wan Chen
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Minimally Invasive ◽  
Femoral Artery ◽  
Femoral Vein ◽  
Vascular Complications ◽  
Minimally Invasive Cardiac Surgery ◽  
Venous Cannulation ◽  
Artery Cannulation ◽  
Short Period

Abstract Background Clinical application of minimally invasive cardiac surgery has increased annually. Cardiopulmonary bypass is established by peripheral cannulation during minimally invasive cardiac surgery. The methodology of peripheral cannulation has unique characteristics, which have associated risks and complications. Few studies have been conducted on this topic. In this study, we focused on complications of peripheral cannulation in totally endoscopic cardiac surgery. Methods Patients who underwent totally endoscopic cardiac surgery with cardiopulmonary bypass established by peripheral cannulation at our institution between January 2019 and June 2020 were reviewed. Specific cannulation strategies and related cannulation complications were noted. Results One hundred forty-eight patients underwent totally endoscopic cardiac surgery. One hundred forty-eight cannulations were performed in the femoral artery and vein, and eleven were performed in the internal jugular vein (combined with the femoral vein). The median size of the femoral artery cannula was 22Fr, and that of the venous canula was 24Fr. One patient died of retroperitoneal haematoma due to femoral artery injury. Three patients had postoperative lower limb oedema. One patient had a postoperative diagnosis of femoral vein thrombosis. Conclusions Different from cannulation in patients with aortic dissection and aneurysms, femoral artery cannulation is safe in totally endoscopic cardiac surgery. Venous cannulation is characterized by a large-bore venous cannula and a short period of use. There are few reports about complications of venous cannulation. The main complication in this study was mechanical injury, and the key to preventing this injury is meticulous manipulation during surgery.

Result of minimally invasive cardiac surgery in Thong Nhat Hospital

2020 ◽  
Vol 10 (4) ◽  
Author(s):  
Kim Que Do ◽  
Keyword(s):  
Cardiac Surgery ◽  
Minimally Invasive ◽  
Left Atrial ◽  
Septal Defect ◽  
Femoral Vein ◽  
Atrial Myxoma ◽  
Minimally Invasive Cardiac Surgery ◽  
Female Ratio ◽  
Off Pump ◽  
Left Atrial Myxoma

Abstract Introduction: Minimally invasive surgery has been a trend in modern medicine and there are no exceptions in the cardiothoracic surgery, which has been widely applied in Vietnam recently. Thong Nhat Hospital has deployed the minimally invasive cardiac surgery (MICS) for a trial septal defect (ASD) and left atrial myxoma since July 2018. Therefore we conducted this research to evaluate the result of this novel method in our hospital thus improving techniques and refining the procedures. Subjects and methods: We retrospectively reviewed all the patients underwent video assisted MICS in Thong Nhat Hospital from July 2018 to February 2020. Results: There had a total of 12 patients, in which 10 had an Atrial Septal Defect(ASD) and 2 had left atrial myxomal. Male/Female ratio was 1:1, mean age was 44,2 ± 4,5. All patients were intubated with double lumen endotracheal tube. Patients were put on cardiopulmonary bypass(CPB) with femoral artery cannula and bicaval cannulas achieved with right femoral vein and right internal jugular vein cannulation. Mean CPB duration was 98,6 ± 13,6 minutes (70 - 155), aortic cross-clamping duration was 44,2 ± 6,8 minutes (0 - 88), there were 5 cases underwent off - pump ASD closure. 1 case had post-op hemorrhage that required reoperation, cause of hemorrhage was due to injury to the internal thoracic artery, there was no death. Conclusions: The application of MICS in treating ASD and left atrial myxoma showed positive short and medium term results, there was no severe complications or death.

Complications of Cardiac Surgery in Children

1987 ◽  
Vol 9 (5) ◽  
pp. 147-154 ◽  
Author(s):  
Mary Allen Engle ◽  
John E. O'Loughlin
Keyword(s):  
Cardiac Surgery ◽  
Heart Surgery ◽  
Septal Defect ◽  
Circulatory Arrest ◽  
Ductus Arteriosus ◽  
Vascular Ring ◽  
Open Heart Surgery ◽  
Coarctation Of The Aorta ◽  
Direct Vision ◽  
Pulmonic Stenosis

LEARNING CURVE OF CARDIAC SURGERY The era of cardiac surgery to help children with congenital heart disease began in 1939 when Dr Robert Gross successfully tied off a patent ductus arteriosus. The next step, in 1944, by Drs Helen Taussig and Alfred Blalock to create an artificial ductus arteriosus for cyanotic children with deficient pulmonary blood flow, threw open the doors for the creation of diagnostic and surgical treatment teams for "blue" babies and others with simple anomalies. Coarctation of the aorta, vascular ring, and pure pulmonic stenosis were anomalies amenable to surgery by 1949. By the early 1950s, use of surface hypothermia and brief periods of circulatory arrest improved the results of pulmonary valvotomy for pulmonic stenosis by permitting incisions of fused commissures under direct vision. Hypothermic arrest also permitted closure of secundum atrial septal defects. Lillehei's pioneering of extra-corporeal circulation in the middle 1950s expanded the surgical horizons by permitting longer periods for repair under direct vision for patients with ventricular septal defect, tetralogy of Fallot, and ostium primum type of atrial septal defect. A decade later, the venous switch type of physiologic repair of complete transposition of the great arteries was developed and perfected. In the early 1970s, miniaturization of equipment brought the age for safe open heart surgery from 5 years or oler down too early infancy.

Limb ischaemia and below-knee amputation following life-saving patent ductus arteriosus stent in a critically ill infant

2014 ◽  
Vol 25 (6) ◽  
pp. 1206-1209
Author(s):  
Apinya Bharmanee ◽  
Srinath Gowda ◽  
Harinder R. Singh
Keyword(s):  
Ventricular Septal Defect ◽  
Patent Ductus Arteriosus ◽  
Septal Defect ◽  
Ductus Arteriosus ◽  
Limb Ischaemia ◽  
Knee Amputation ◽  
Pulmonary Flow ◽  
Life Saving ◽  
Acute Limb Ischaemia ◽  
Patent Ductus

AbstractLimb ischaemia is a rare but catastrophic complication related to cardiac catheterisation. We report an infant weighing 3 kg with unrepaired tricuspid atresia type 1b, small patent ductus arteriosus, and ventricular septal defect presenting with cardiogenic shock owing to progressively reduced pulmonary blood flow from closing ventricular septal defect and patent ductus arteriosus. An emergency palliative ductal stent was successfully placed with marked clinical improvement. However, acute limb ischaemia developed necessitating above-knee amputation, despite medical management and vascular surgery. The cause of limb loss in our patient was catheterisation-related vascular injury causing arterial dissection–arterial thrombosis in the presence of shock and coagulopathy. This report emphasises the complexity in managing limb ischaemia associated with coagulopathy and highlights the importance of early recognition of reduced pulmonary flow in a single ventricle patient. Timely elective placement of a surgical systemic to pulmonary shunt would prevent catastrophic clinical presentation of compromised pulmonary flow and avoid the need for an emergent life-saving intervention and its associated complications.

Arterial Injuries from Femoral Artery Cannulation with Port Access Cardiac Surgery

2005 ◽  
Vol 39 (2) ◽  
pp. 153-158 ◽  
Author(s):  
Bart E. Muhs ◽  
Aubrey C. Galloway ◽  
Michael Lombino ◽  
Michael Silberstein ◽  
Eugene A. Grossi ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Femoral Artery ◽  
Artery Cannulation ◽  
Arterial Injuries ◽  
Port Access

scholarly journals A novel cannulation technique for difficult urethral catheterization

2016 ◽  
Vol 88 (1) ◽  
pp. 60 ◽  
Author(s):  
Mehmet Kaynar ◽  
Murat Akand ◽  
Serdar Goktas
Keyword(s):  
Guide Wire ◽  
Foley Catheter ◽  
Catheter Placement ◽  
Direct Vision ◽  
Intravenous Catheter ◽  
Urethral Catheterization ◽  
Side Hole ◽  
Cannulation Technique ◽  
Catheter Tip

Introduction: To propose a novel cannulation technique for difficult urethral catheterization procedures. Technique: The sheath tip of an intravenous catheter is cut off, replaced to the needle tip and pushed through the distal drainage side hole to Foley catheter tip, and finally withdrawn for cannulation. In situations making urethral catheterization difficult, a guide wire is placed under direct vision. The modified Foley catheter is slid successfully over the guide wire from its distal end throughout the urethral passage into the bladder. Results: The modified Foley catheter was used successfully in our clinic in cases requiring difficult urethral catheterization. Conclusions: This easy and rapid modification of a Foley catheter may minimize the potential complications of blind catheter placement in standard catheterization.

scholarly journals Case Report: Ascending Aortic Pseudo-Aneurysm Following Ventricular Septal Defect Repair in a 4-Year-Old Girl

2021 ◽  
Vol 9 ◽  
Author(s):  
Xinya Li ◽  
Hong Zhou ◽  
Rui Zhang ◽  
Jing Zhao ◽  
Tian Li ◽  
...  
Keyword(s):  
Case Report ◽  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Circulatory Arrest ◽  
Massive Hemorrhage ◽  
Purse String ◽  
Defect Repair ◽  
Life Threatening ◽  
Pseudo Aneurysm ◽  
Computed Tomograph

Pseudo-aneurysm is a fatal disease, and the main cause of death is massive hemorrhage secondary to the rupture of the aneurysm. This case report aims to evaluate the effects of pseudo-aneurysm excision procedure on the disease. A 4-year-old girl was readmitted on the 20th day after ventricular septal defect (VSD) closure procedure with a high fever of 40°C; aortic pseudo-aneurysm was suspected based on a spherical cystic echo (82 × 76 mm) of the ascending aorta which was detected by ultrasonic cardiogram, and the diagnosis was confirmed by an aortic computed tomograph angiography (CTA) examination and intraoperative findings. Treatment included emergency pseudo-aneurysm excision procedure and antibiotic therapy. The aortic pseudo-aneurysm was surgically removed under deep hypothermia and circulatory arrest. Antibiotics were applied according to the bacterial culture results. The pseudo-aneurysm was excised successfully, and the patient achieved a good recovery. Our case suggests that the postoperative ascending aortic pseudo-aneurysm was probably due to inappropriate purse-string suture and/or local or systematic infection, so extra precautions should be taken to avoid this life-threatening complication.

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