Direct Cannulation in Minimally Invasive Cardiac Surgery With Limited Resources

Abstract

Background. With increasing patient interest in minimally invasive procedures, it is more important than ever for surgeons to be current on the most common minimally invasive techniques in cardiac surgery. As minimally invasive cardiac surgery has evolved, the strategies and approaches to cardiopulmonary bypass access have evolved. Peripheral cannulation is convenient but carries a risk of retrograde dissection, embolization, stroke, and ipsilateral limb ischemia, whereas central aortic cannulation has the advantage of antegrade flow.Methods. We report our experience with direct arterial and venous cannulation through a thoracotomy approach without compromising the results. From January 2017 to December 2018, 140 consecutive patients were studied. Mean age was 26 ± 18 years (range, 11 months to 83 years), with 46 patients (32.8%) younger than 12 years and 12 patients weighing less than 10 kg. Spectrum of procedures include atrial septal defect closure (53%), mitral valve repair (14%), ventricular septal defect closure (9%),

Early Outcome of Mitral Valve Surgery comparing Minimally Invasive Versus Standard Median Sternotomy Approach

“…Peripheral cannulation and retrograde arterial perfusion carried a risk of retrograde dissection, embolization, and ipsilateral limb ischemia and was associated with an increased risk of stroke in patients with severe peripheral vascular disease (PVD) [9,10]. In our study, full clinical history, CT aortography, and with TEE guidance all those complications were avoided.…”

Analysis of the logistical, economic and minimally invasive cardiac surgical training difficulties in India

“…Certain other indigenous methods have also been put to practice in the Indian scenario to circumvent the higher cost of peripheral cannulation. Kandakure et al [ 22 ] report the routine use of direct cannulation in MICS in centres with limited resources to mitigate the cost as regular instruments and cannulae are used. Over a 2-year period (January 2017 – December 2018), the authors report a total of 140 cases of MICS (ASD closure (53%), mitral valve repair (14%), VSD closure (9%), aortic valve replacement (10%), mitral valve replacement (6%), repair of PAPVC (9%), myxoma excision (1%), VSD closure with pulmonary valvotomy (1%)), being performed with central cannulation.…”

Central and Peripheral Cannulation for Cardiopulmonary Bypass in Fetal Sheep: A Comparative Study

“…Peripheral cannulation technology is mainly applied in ECMO and in recent years has been increasingly adopted in thoracoscopic or redo cardiac surgery ( 24 , 25 ). The most common vessels for peripheral cannulation include the femoral artery and vein, followed by the axillary artery, carotid artery and jugular vein ( 26 , 27 ).…”