Versatility of endoaortic balloon occlusion device for less invasive management of complex and reoperative cardiac cases

Abstract

Heart Teams are increasingly confronted with decision‐making in anatomically and clinically complex surgical candidates. Herein, we discuss the versatility of the endoaortic occlusion device (Intraclude; Edwards Lifesciences Inc) for the management of a various array of complex primary and reoperative cardiac cases. Three clinical scenarios are illustrated (ascending aortic pseudoaneurysm, mitral valve surgery after previous CABG, extensive thoracic aortic surgery with continuous visceral perfusion), suggesting the effectiveness of the patient‐specific strategy to minimize operative morbidity. Evolution of surgical techniques needs to be considered in decision‐making among alternative treatment strategies.

Long-term results of endoclamping in patients undergoing minimally invasive mitral valve surgery where external aortic clamping cannot be used – a propensity matched analysis

“…Despite this, the long-term (7-year) survival rates for patients were similar in both groups at our centre. Endoaortic balloon occlusion is a versatile tool with applicability for a range of cardiac surgeries [22]. In general, certain measures are vital to ensure the safe performance of endoclamping.…”

“…Endoaortic balloon occlusion is a versatile tool with applicability for a range of cardiac surgeries [ 22 ]. In general, certain measures are vital to ensure the safe performance of endoclamping.…”

“…In general, certain measures are vital to ensure the safe performance of endoclamping. Viability should be confirmed using preoperative imaging [ 22 ]. Transoesophageal echocardiographic monitoring is vital to control guidewire advancement and ensure correct positioning of the endoclamp [ 4 , 10 , 22 ].…”

“…Viability should be confirmed using preoperative imaging [ 22 ]. Transoesophageal echocardiographic monitoring is vital to control guidewire advancement and ensure correct positioning of the endoclamp [ 4 , 10 , 22 ]. Changing the balloon position after the initial endoclamping has been undertaken is possible under echocardiographic surveillance and with partial deflation of the balloon to avoid damaging the aortic wall [ 22 ].…”

“…Transoesophageal echocardiographic monitoring is vital to control guidewire advancement and ensure correct positioning of the endoclamp [ 4 , 10 , 22 ]. Changing the balloon position after the initial endoclamping has been undertaken is possible under echocardiographic surveillance and with partial deflation of the balloon to avoid damaging the aortic wall [ 22 ]. It has been shown that MIMVS using endoclamping is a safe procedure even during the initial learning curve [ 11 ].…”