Percutaneous placement of large cannula into the internal jugular vein for minimally invasive surgery: Where do we go?

Successful Double-Catheter Coil Embolization of an Iatrogenic Subclavian Artery to Internal Jugular Vein Fistula After Minimally Invasive Cardiac Surgery

“…The performance of MICS through a small thoracotomy has been increasing because of the rapid recovery time and the cosmetic advantages. 1 A recent German study showed that 43.2% of isolated mitral valve surgeries were performed by MICS, 10 and accumulation of additional experiences has led to MICS becoming an established option for mitral valve repair. Nishi et al 11 evaluated the current status of mitral valve repair by MICS using a nationwide surgical database and found that 15.6% of mitral valve repairs were performed by MICS in 2012 and that the 30-day mortality rate was 0.3%.…”

“…A 15-to 21-French cannula may be inserted percutaneously via the right IJV; however, this cannula is considerably larger than the multilumen 7-to 9-French catheter inserted into the IJV for hemodynamic monitoring and administration of fluid and vasoactive medications. 1 The incidence of catheter-related complication in MICS is reported as 0.68% to 4.3% [5][6][7] ; however, these vascular injuries can lead to devastating complications if a large-bore cannula is inadvertently inserted too deeply. To avoid vascular complications during MICS, routine use of transesophageal echocardiography is recommended to monitor the tip of the cannula placed in the SVC.…”

“…Minimally invasive cardiac surgery (MICS) has evolved during the last decade partly because of the reduced length of hospitalization, improvements in patients' satisfaction with the cosmetic results, and achievement of outcomes comparable to those of traditional cardiac surgery. 1,2 During MICS, it is essential to establish cardiopulmonary bypass (CPB) by percutaneous insertion of a large cannula because of the restricted operative field. Superior vena cava (SVC) drainage can be achieved by percutaneous insertion of a large-bore cannula via the right internal jugular vein (IJV).…”