Percutaneous femoral cannulation and decannulation using a plug-based vascular closure device in minimally invasive cardiac surgery

2020 ◽  
Keyword(s):  
Cardiac Surgery ◽  
Mitral Valve ◽  
Minimally Invasive ◽  
Extracorporeal Circulation ◽  
Minimally Invasive Cardiac Surgery ◽  
Closure Device ◽  
Arterial Cannulation ◽  
Vascular Closure Device ◽  
Video Tutorial ◽  
Percutaneous Cannulation

Minimally invasive cardiac surgery such as a mitral valve procedure requires femoral arterial cannulation for extracorporeal circulation. To avoid complications associated with surgical groin incisions, such as seromas and infections, percutaneous cannulation techniques can be used. This video tutorial illustrates percutaneous femoral cannulation and decannulation using a plug-based vascular closure device.

Evolution of Cannulation Techniques for Minimally Invasive Cardiac Surgery a 10-Year Journey

2012 ◽  
Vol 7 (1) ◽  
pp. 9-14 ◽  
Author(s):  
Edward Y. Chan ◽  
Dennis M. Lumbao ◽  
Alexander Iribarne ◽  
Rachel Easterwood ◽  
Jonathan Y. Yang ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Minimally Invasive ◽  
Vena Cava ◽  
Minimally Invasive Cardiac Surgery ◽  
Aortic Occlusion ◽  
Complication Rates ◽  
Venous Cannulation ◽  
Arterial Cannulation ◽  
Dual Stage ◽  
Over Time

Objective For minimally invasive cardiac surgery (MICS) procedures requiring cardiopulmonary bypass (CPB), cannulation techniques vary and seem to be important determinants of technical difficulty and clinical outcomes. Over 10 years of MICS, we have modified our techniques substantially, and the present report outlines the evolution of our current cannulation platform. Methods From October 2000 to November 2010, 1087 minimally invasive cardiac procedures were performed at our institution; of these, 165 were done without CPB and were excluded. Methods of arterial and venous cannulation and aortic occlusion were retrospectively reviewed. Outcomes of interest included CPB and aortic cross-clamp time, as well as rates of in-hospital stroke, myocardial infarction, and short- and long-term mortality. Results The mean age of the study population was 57 ± 15 years, with 50% being men. The MICS procedures included mitral valve surgery, atrial septal defect repair, atrial fibrillation ablation, and cardiac tumor resections. Over the study period, peripheral arterial cannulation was replaced by central aortic cannulation, which was used in 33% of patients in 2000–2001 and 93% in 2008–2010. Venous cannulation strategies also evolved over time, from percutaneous neck and femoral (78% of cases from 2000–2005), to direct superior vena cava and percutaneous femoral (67% in 2006–2007), to percutaneous dual-stage femoral (51% in 2008–2010). Aortic occlusion was achieved by endoaortic balloon in 33% of cases in 2000–2001 but, by 2002, was replaced by transaxillary clamp occlusion and direct antegrade/retrograde cardioplegia. In the post-endoballoon era, CPB and cross-clamp times have remained consistent. Overall, there were nine strokes (<1.0%), no myocardial infarctions, and 18 deaths (2.0%) within 30 days of surgery, and the incidence of these outcomes has not changed over time. Conclusions Over 10 years, our cannulation strategy for MICS has evolved to favor central aortic over femoral arterial cannulation, percutaneous femoral dual-stage bicaval venous drainage over percutaneous neck access, and transaxillary clamping over endoaortic balloon occlusion of the aorta. In our experience, this approach has resulted in low complication rates and a reliable platform for a variety of MICS procedures.

The MANTA Vascular Closure Device for Percutaneous Femoral Vessel Cannulation in Minimally Invasive Surgical Mitral Valve Repair

2020 ◽  
Vol 15 (6) ◽  
pp. 568-571
Author(s):  
Karel M. Van Praet ◽  
Markus Kofler ◽  
Stephan Jacobs ◽  
Volkmar Falk ◽  
Axel Unbehaun ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Mitral Valve Repair ◽  
Closure Device ◽  
Valve Repair ◽  
Vascular Closure Device ◽  
Arterial Access ◽  
Minimally Invasive Surgical ◽  
Posterior Mitral Leaflet ◽  
Leaflet Prolapse

A 65-year-old Caucasian male was referred to our institution with severe mitral regurgitation due to posterior mitral leaflet prolapse. The patient underwent minimally invasive surgical mitral valve repair. Here we present the application of a new vascular closure device (MANTA) for percutaneous arterial access and closure.

Femoral cannulation for cardiopulmonary bypass with a novel bidirectional perfusion cannula

2021 ◽  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Mitral Valve ◽  
Minimally Invasive ◽  
Femoral Artery ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
The Novel ◽  
Postoperative Course ◽  
Video Tutorial ◽  
Percutaneous Cannulation

The use of the novel bidirectional femoral cannula is described in this video tutorial. We demonstrate the percutaneous cannulation and decannulation of the femoral artery for cardiopulmonary bypass in a patient undergoing minimally invasive mitral valve surgery. The procedure itself is presented step by step for each important phase. Finally, we report the postoperative course following the successful use of a peripheral bidirectional cannula.

A Case of Coronary Artery Fistula Ligation in Minimally Invasive Mitral Valve Plasty via Right Anterolateral Minithoracotomy

2019 ◽  
Vol 14 (2) ◽  
pp. 174-176
Author(s):  
Nobuo Kondo ◽  
Toshinori Totsugawa ◽  
Hidenori Yoshitaka ◽  
Taichi Sakaguchi
Keyword(s):  
Cardiac Surgery ◽  
Coronary Artery ◽  
Mitral Valve ◽  
Minimally Invasive ◽  
Present Method ◽  
Coronary Artery Fistula ◽  
Minimally Invasive Cardiac Surgery ◽  
Mitral Valve Plasty ◽  
Safe Option ◽  
Heart Beating

We report a case of coronary artery fistula treated by ligation with concomitant minimally invasive mitral valve plasty via right anterolateral minithoracotomy. The coronary artery fistula was isolated well under heart beating, and clip-ligation was easily and safely performed. The present method is an effective and safe option for use with minimally invasive cardiac surgery.

Percutaneous Vascular Closure Device in Minimally Invasive Mitral Valve Surgery

2020 ◽  
Vol 110 (1) ◽  
pp. 85-91 ◽  
Author(s):  
Mikael Kastengren ◽  
Peter Svenarud ◽  
Göran Källner ◽  
Magnus Settergren ◽  
Anders Franco-Cereceda ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Closure Device ◽  
Vascular Closure Device

Fifty Percent Reduction in Narcotic Use After Minimally Invasive Cardiac Surgery Using Liposomal Bupivacaine

2019 ◽  
Vol 14 (6) ◽  
pp. 512-518
Author(s):  
Mario Castillo-Sang ◽  
Cheryl Bartone ◽  
Cassady Palmer ◽  
Vien T. Truong ◽  
Brian Kelly ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Postoperative Pain ◽  
Mitral Valve ◽  
Length Of Stay ◽  
Minimally Invasive ◽  
Hospital Length ◽  
Minimally Invasive Cardiac Surgery ◽  
Hospital Length Of Stay ◽  
Liposomal Bupivacaine ◽  
Asd Closure

Objective Minimally invasive cardiac surgery via a right minithoracotomy (RMT) is a common approach to different valve pathologies, tumor resection, and atrial septal defect (ASD) closure. We studied intraoperative field block using liposomal bupivacaine (LB) in these operations. Methods Consecutive 171 minimally invasive RMTs (fourth intercostal space) were studied, and patients in cardiogenic or septic shock, intravenous drug abuse, and those re-explored were excluded ( n = 12). An early cohort was treated with standard postoperative analgesia while another underwent intraoperative field block with LB immediately after incision. We compared postoperative pain level, narcotic utilization (morphine milligram equivalent), and intensive care unit (ICU) and hospital length of stay. Results The procedures included 48 isolated mitral valve replacements (MVR); 2 MVR with other procedures; 93 mitral valve repairs (MVRr); 9 MVRr with other procedures; 4 isolated tricuspid valve repairs; 2 myxoma resections; 1 ASD closure. There were 13 patients in the non-LB group and 146 patients in the LB group. Use of LB decreased mean postoperative narcotic utilization by 50% ( P = 0.003). The LB group had lower pain levels on postoperative day 1 ( P = 0.039), which continued through postoperative day 5 ( P = 0.030). We found no difference in ICU or hospital length of stay between groups. There were no complications from LB field block. Conclusions LB field block decreases postoperative pain and narcotic utilization after cardiac surgery via a RMT, but it does not reduce length of stay. The technique is safe and should be considered in all patients undergoing RMT cardiac surgery.

scholarly journals Three-Dimensional Printing of Life-Like Models for Simulation and Training of Minimally Invasive Cardiac Surgery

2017 ◽  
Vol 12 (6) ◽  
pp. 459-465 ◽  
Author(s):  
Toshiyuki Yamada ◽  
Motohiko Osaka ◽  
Tomoya Uchimuro ◽  
Ryogen Yoon ◽  
Toshiaki Morikawa ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Mitral Valve ◽  
Minimally Invasive ◽  
Three Dimensional ◽  
Minimally Invasive Cardiac Surgery ◽  
Valve Repair ◽  
Three Dimensional Printing ◽  
Simulation And Training ◽  
Dimensional Printing ◽  
And Training

Objective As the use of minimally invasive surgery in cardiothoracic surgery increases, so does the need for simulation and training. We developed a heart model for simulation and training of minimally invasive cardiac surgery, particularly minimally invasive mitral valve repair using our new three-dimensional printing system. Methods Digital imaging and communication in medicine data from patient computed tomography, three-dimensional computer-aided design, and three-dimensional printing helped create replicas of the heart and thoracic cavity. A polyvinyl alcohol model material with a texture and physical properties similar to those of heart tissue was initially used in mitral valve replicas to simulate surgical procedures. To develop this material, we mechanically investigated the composition of each part of the porcine heart. Results We investigated the elastic modulus and breaking strength of the porcine heart. Based on investigation results, the cardiac model was set at rupture strength 20 MPa, elastic modulus 0.17 MPa, and moisture content 85%. This provided a biotexture and feeling exactly like a patient heart. Computed tomography scans confirmed that the model shape was nearly the same as that of a human heart. We simulated minimally invasive mitral valve repair, including ring annuloplasty, chordal reconstruction, resection and suture, and edge-to-edge repair. Full surgery simulations using this model used minimally invasive cardiac surgery tools including a robot. Conclusions This life-like model can be used as a standard simulator to train younger, less experienced surgeons to practice minimally invasive cardiac surgery procedures and may help develop new operative tools.

Role of Preoperative Femoral Artery Color Doppler Echocardiography in Minimally Invasive Cardiac Surgery

2012 ◽  
Vol 7 (6) ◽  
pp. 441-444 ◽  
Author(s):  
Fabrizio Ceresa ◽  
Fabrizio Sansone ◽  
Francesco Patanè
Keyword(s):  
Cardiac Surgery ◽  
Minimally Invasive ◽  
Femoral Artery ◽  
Doppler Echocardiography ◽  
Color Doppler ◽  
Preoperative Evaluation ◽  
Minimally Invasive Cardiac Surgery ◽  
Arterial Cannulation ◽  
Color Doppler Echocardiography ◽  
Linear Probe

Objective Minimally invasive cardiac surgery (MICS) through a right thoracotomy has been developed in the past decades, leading to a significant improvement of postoperative outcome. The risk for complications during peripheral cannulation should be considered. We report our experience of preoperative evaluation by color Doppler echocardiography for patients scheduled for MICS. Methods Between January 2009 and December 2011, a total of 155 patients were operated on for mitral valve disease or patent foramen ovale. One hundred thirteen patients were approached by MICS through the fourth intercostal space, and arterial cannulation was peripheral (femoral artery). One hundred nineteen patients scheduled for MICS were screened by ultrasound evaluation before the induction of anesthesia, by means of a vascular linear probe. Three parameters were considered: longitudinal axis, transverse axis, and atherosclerotic disease (AD). Results Peripheral arterial cannulation of vessels greater than 7 mm is safe because we experienced no complications in 69 patients. In case of diameters 6.5 to 7 mm, peripheral cannulation should be avoided in case of presence of calcifications; in fact, three patients in our series with AD had vascular injuries; 25 patients without femoral artery AD had no complications. Cannulation was avoided in six patients with widespread AD. In case of diameters less than 6.5 mm, peripheral cannulation was avoided. Conclusions Peripheral cannulation is safe when a careful preoperative evaluation is performed. The diameters of the femoral vessels are predictors of complications in case of absence of other contraindications.

scholarly journals Ascending aorta cannulation in totally thoracoscopic minimally invasive cardiac surgery

2020 ◽  
Author(s):  
Shengjie Liao ◽  
Xiaoshen Zhang
Keyword(s):  
Cardiac Surgery ◽  
Minimally Invasive ◽  
Femoral Artery ◽  
Extracorporeal Circulation ◽  
Ascending Aorta ◽  
Minimally Invasive Cardiac Surgery ◽  
Artery Cannulation ◽  
Aortic Cannulation ◽  
Alternative Approach

The Cannulation through the femoral artery is the preferred method of establishing peripheral extracorporeal circulation in totally thoracoscopic minimally invasive cardiac surgery (MICS). However, facing to contraindications of femoral artery cannulation, a modified aortic cannulation is an alternative approach for totally thoracoscopic MICS.

Sign in / Sign up

Export Citation Format

Share Document