Percutaneous cannulation for cardiopulmonary bypass in minimally invasive surgery is associated with reduced groin complications

Abstract

Percutaneous groin cannulation using ACDs for establishing cardiopulmonary bypass in minimally invasive valve surgery significantly reduces groin complications, operation time and hospital stay. However, the remaining complications are mainly of vascular nature versus wound infection and lymph fistulae with cutdown.

The Opportunities and Limitations of Minimally Invasive Cardiac Surgery

“…These results are consistent with our own experiences (Färber et al, 2017 annual meeting of the German Society for Thoracic and Cardiovascular Surgery [Deutsche Gesellschaft für Thorax-, Herz-und Gefäßchirurgie, DGTHG]. Additionally, we showed in a recent analysis including more than 450 patients that percutaneous femoral vessel cannulation reduces local complication rates significantly (20).…”

“…In our experience, this problem is rare (in our subjective perception/observation <1%). However, we undertake doublelumen endotracheal intubation and one-lung ventilation only in exceptional circumstances (20). From an anesthesiologic perspective, minimally invasive access to the heart allows a greater degree of flexibility in administering anesthesia and in postoperative care in the intensive care ward.…”

“…We can only repeat our recommendation to attend specialized centers (5,25). In such centers, these procedures are even now part of the standard healthcare repertoire (20,31,32).…”

Minimally‐invasive parasternal aortic valve replacement–A slow learning curve towards improved outcomes

“…At the end of the procedure the pericardium was closed, the rib reattached with a 1‐0 vicryl suture and the wound closed in layers. CPB was ended and the Proglide system was used to close the arterial puncture site . Figure shows the operative setup, the way a classical stented valve is brought into the situs and the postoperative cosmetic result.…”

“…For parasternal AVR, cardiopulmonary bypass (CPB) was established using percutaneous groin cannulation as described elsewhere. 7 Central cannulation was used for severe peripheral artery disease in three cases. A 5 cm right parasternal incision over the second intercostal space was made and the pleural space was opened.…”