Outcomes of with open and Seldinger-Guided Peripheral Cannulation Techniques in open heart surgery

Abstract

In this study, we evaluated the results of open access and seldinger guided peripheral cannulation techniques in patients which underwent open heart surgery. Materials and Method: The results of heart surgery cases with peripheral artery and vein open access technique and seldinger guide technique between November 2010 and October 2017 were evaluated retrospectively. Edwards® Fem-Flex II and Medtronic Bio-Medicus™ NextGen percutaneous femoral artery and venous Cannulas were chosen. Peripheric cannulations were performed percutaneously with doppler ultrasonography via guided seldinger technique. Seldinger technique for peripheric cannulation was preferred even open exploration of the groin vessels were needed. Results: 65 patients (32 male, 33 female; mean age 43±37 years; range 3-81 years) were taken into the study that peripheral cannulation performed. In 18 (27.6%) patients minimally invasive technique was applied and 34 (52.3%) patients were redo cases. A mean flow of 4,108±0.6 m2 l/m2/m was achieved with vacuum application in only 6 patients (9.2%) for venous drainage. No hemothorax, pneumothorax or hematoma had occured in cannulation sites due to internal jugular vein or femoral cannulations. Surgical embolectomy was performed due to distal thrombus only in 4 patients (6.15%) to whom had conventional cannulation. In 4 patients (6.15%) femoral venous cannula couldn't reached up to the right atrium. Conclusion: In our opinion, seldinger technique either performed percutaneously or surgically is a faster, easier and superior technique in protecting distal limb perfusion when compared with open vasculotomy with proximal/distal clamping technique. Moreover, it can be safely applied in high risk redo cases as well as routine minimally invasive surgery.