An institution's initial experience with port-access minimally invasive cardiac surgery

Minimally invasive endoscopic port‐access™ intracardiac surgery with one lung ventilation: impact on gas exchange and anaesthesia resources

“…Endovascular aortic occlusion, antegrade cardioplegia delivery and integrity of cerebral perfusion There have been several reports describing surgical instrumentation techniques for minimally invasive coronary and intracardiac surgery [9,11]. In our study, monitoring of adequate endo-aortic balloon placement and occlusion was accomplished by TOE imaging of the ascending aorta, aortic root and balloon pressure measurements, and by comparison of parallel left and right radial artery pressure measurements.…”

“…Similar to other studies [9][10][11], a percutaneous cannulation technique was used to insert the large-bore superior vena cava cannula via the right jugular vein, but retrograde cardioplegia via a percutaneous coronary sinus catheter [10] was not performed. Two patients had complications related to superior vena cava cannula placement; one of them suffered azygos vein rupture with bleeding and required median sternotomy.…”

“…The heart is arrested by antegrade cardioplegia following endo-aortic balloon occlusion. As the feasibility and safety of this catheter-based system has been shown in animals [2,6] and patients [7][8][9][10][11], it has now entered clinical practice. However, introduction of these new techniques challenges the anaesthetist, in particular with regard to cannulation, one lung ventilation (OLV), increased monitoring needs and, mostly likely, a need for greater resources.…”

Anesthetic considerations for a steroid-dependent high-risk patient undergoing minimally invasive cardiac surgery

“…Achieving these anesthetic goals may be challenging. 3 A 54-yr-old female patient weighing 80 kg presented with shortness of breath. She was diagnosed with right-sided congestive heart failure from a large ostium secundum ASD and severe mitral regurgitation (MR).…”

“…Despite the fact that ondansetron has no clear-cut ability to block dopamine receptors (an effect necessary to induce EPS), 3 anti-dopaminergic adverse effects (EPS) have been described, especially …”