Right-sided Reverse T Composite Arterial Grafting to Complete Revascularization of the Right Coronary Artery

Aazami, Mathias H.; Abbasi-Teshnizi, Mohammad; Amini, Shahram; Lotfinejad, Nasim

doi:10.5935/1678-9741.20140069

Cited by 1 publication

(1 citation statement)

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“…When proceeding to coronary artery bypass grafting, the appropriate length of the grafts should be measured preprocedurally on the fully beating heart, to reduce errors in estimating graft lengths under the unloaded heart. 12 We expect that the hemodynamic data provided by the current series will have a positive impact on future perfusion strategies. This technique's 64% ratio of the mean indexed LBCV drainage-to-calculated pump flow should aid decision-making with regard to emerging intrathoracic-yet extracardiac-connections for partial and mini-extracorporeal circulation technology, on-pump beating-heart approaches, and short-term circulatory assist-device implantation.…”

Section: Discussionmentioning

confidence: 91%

Left Brachiocephalic Vein Cannulation in Bicaval Venous Drainage Is Safe, Effective, and Technically Advantageous

Aazami¹,

Gholoobi²,

Amini³

et al. 2016

Texas Heart Institute Journal

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Direct cannulation of both venae cavae (bicaval venous cannulation) is the gold standard for right atrial isolation in intracavitary surgery, but there has been no consensus about an alternative site. Therefore, we studied an alternative method for bicaval venous drainage in which the left brachiocephalic vein (LBCV) is cannulated instead of the superior vena cava. From 2012 through 2014, we performed routine LBCV cannulation in 150 consecutive patients as part of bicaval venous drainage before right atrial isolation. We prospectively collected demographic information, operative data, total pump and LBCV cannula flows with their respective calculated and indexed rates, central venous pressures, and perioperative complications. All patients survived surgery. There were no adverse technical outcomes or functional deficits associated with the technique. The mean indexed LBCV cannula flow was 1,520 ± 216 mL/min/m(2), representing an LBCV cannula-to-calculated pump-flow ratio of 64%. The mean central venous pressure during right atrial isolation was 3.7 ± 1.9 mmHg. Cannulation of the LBCV is intrinsically a safe and reproducible procedure with proven hemodynamic adequacy. Its versatility can be an asset to surgical techniques and perfusion methods. Furthermore, the hemodynamic results in our series promise alternative intrathoracic and extracardiac cannulation sites for mini-extracorporeal circulation, on-pump beating-heart procedures, and short-term circulatory assist device implementation.

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Section: Discussionmentioning

confidence: 91%