Percutaneous coronary sinus cannulation guided by transesophageal echocardiography

Plotkin, Igor M.; Collard, Charles D.; Aranki, Sary F.; Rizzo, Robert J.; Shernan, Stanton K.

doi:10.1016/s0003-4975(98)01068-6

Cited by 25 publications

(12 citation statements)

References 5 publications

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“…An additional option is the use of a percutaneous coronary sinus catheter. 42,43 The Endopledge Coronary Sinus Catheter (Edwards Lifesciences) is advanced through an 11-French introducer sheath, typically via the right IJ vein. It is a long triplelumen catheter with a balloon on the end that allows for occlusion of the coronary sinus, measurement of distal pressure, and the infusion of cardioplegia.…”

Section: Cardioplegiamentioning

confidence: 99%

Anesthetic Considerations During Minimally Invasive Mitral Valve Surgery

Vernick

Woo

2012

Semin Cardiothorac Vasc Anesth

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Advances in instruments and visualization tools as well as circulatory systems for cardiopulmonary bypass during the late 1990s have stimulated widespread adoption of minimally invasive mitral valve surgery (MIMVS). Today, MIMVS is the standard approach for many surgeons and institutions. There are multiple benefits of MIMVS. Patient satisfaction and improved cosmesis are important. Additionally, studies have consistently shown faster recovery times and less associated pain with MIMVS. Statistically significant improvement in bleeding, transfusion, incidence of atrial fibrillation, and time to resumption of normal activities with MIMVS has also been shown when comparing MIMVS with conventional mitral surgery. Most important, these benefits have been achieved without sacrificing perioperative safety or durability of surgical repair. Although a steep learning curve still exists given the high level of case complexity, continued development fueled by increasing patient demand may allow for even further expansion in the use of minimal invasive techniques.

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Section: Cardioplegiamentioning

confidence: 99%

Anesthetic Considerations During Minimally Invasive Mitral Valve Surgery

Vernick

Woo

2012

Semin Cardiothorac Vasc Anesth

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“…Arrhythmias may frequently occur during the catheter manipulation. Plotkin et al reported that two out of 11 patients developed transient atrial fibrillation during the CSC placement; one required cardioversion [ 16 ]. Arrhythmias often cease once the catheter manipulation halts; however, it may be wise to place external cardioverter–defibrillator patches on every patient before the catheter insertion in case prolonged arrhythmias occur.…”

Section: Discussionmentioning

confidence: 99%

Initial experience with percutaneous coronary sinus catheter placement in minimally invasive cardiac surgery in an academic center

et al. 2015

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BackgroundPlacement of a percutaneous coronary sinus catheter (CSC) by an anesthesiologist for retrograde cardioplegia in minimally invasive cardiac surgery is relatively safe in experienced hands. However, the popularity of its placement remains limited to a small number of centers due to its perceived complexity and potential complications.MethodsWe retrospectively reviewed all cardiac cases performed by one surgeon between December 2009 and April 2012. The reviewed cases were divided into two groups: cardiac cases with percutaneous CSC placement (CSC group) and cardiac cases without placement (control group). Anesthesia preparation time (APT) was then compared between the CSC group and control group. In the CSC group, cases were further divided into two groups. One group contained cases with an APT of less than 90 min (success group) and the other contained cases with an APT greater than or equal to 90 min or cases with CSC placement failure (delay/failure group). Patients’ characteristics, type of surgery, and transesophageal echocardiography (TEE) findings were compared between the two groups (success group vs. delay/failure group) to identify variables associated with prolongation of the APT or CSC placement failure.ResultsPercutaneous CSC placement was required in 83 cases (CSC group). The catheter was successfully placed in 74 of those cases. We experienced one complication, coronary sinus injury after multiple attempts at placing the catheter. The mean APT was 102 ± 31 min in the CSC group (n = 81) and 42 ± 15 min in the control group (n = 285). We could not identify any variables associated with prolongation of the APT or catheter placement failure.ConclusionsThe success rate of the placement was 89.1 % in our academic center. On average, placing the CSC added approximately one additional hour to the APT. This time is not an accurate representation of true catheter placement time, as it included time for preparation of the CSC, TEE, and fluoroscopy. We experienced one documented complication (coronary sinus injury), which was immediately diagnosed by TEE and fluoroscopy in the operating room. No variables associated with prolongation of APT or CSC placement failure were identified.Electronic supplementary materialThe online version of this article (doi:10.1186/s12871-016-0203-4) contains supplementary material, which is available to authorized users.

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“…Percutaneous cannulation of the CS for administration of retrograde cardioplegia during MICS can be accomplished safely and efficiently using TEE. [18] TEE helps in the navigation of the catheter from SVC to CS through the RA. Midesophageal bicaval view is useful for tracing the catheter from SVC to RA.…”

Section: Retrograde Cardioplegia Deliverymentioning

confidence: 99%

Minimally invasive cardiac surgery and transesophageal echocardiography

2014

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Improved cosmetic appearance, reduced pain and duration of post-operative stay have intensified the popularity of minimally invasive cardiac surgery (MICS); however, the increased risk of stroke remains a concern. In conventional cardiac surgery, surgeons can visualize and feel the cardiac structures directly, which is not possible with MICS. Transesophageal echocardiography (TEE) is essential during MICS in detecting problems that require immediate correction. Comprehensive evaluation of the cardiac structures and function helps in the confirmation of not only the definitive diagnosis, but also the success of surgical treatment. Venous and aortic cannulations are not under the direct vision of the surgeon and appropriate positioning of the cannulae is not possible during MICS without the aid of TEE. Intra-operative TEE helps in the navigation of the guide wire and correct placement of the cannulae and allows real-time assessment of valvular pathologies, ventricular filling, ventricular function, intracardiac air, weaning from cardiopulmonary bypass and adequacy of the surgical procedure. Early detection of perioperative complications by TEE potentially enhances the post-operative outcome of patients managed with MICS.

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Percutaneous coronary sinus cannulation guided by transesophageal echocardiography

Cited by 25 publications

References 5 publications

Anesthetic Considerations During Minimally Invasive Mitral Valve Surgery

Anesthetic Considerations During Minimally Invasive Mitral Valve Surgery

Initial experience with percutaneous coronary sinus catheter placement in minimally invasive cardiac surgery in an academic center

Minimally invasive cardiac surgery and transesophageal echocardiography

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