Remote access perfusion for minimally invasive cardiac surgery: to clamp or to inflate?

作者: C. Krapf , P. Wohlrab , S. Haussinger , T. Schachner , H. Hangler

DOI: 10.1093/EJCTS/EZT070

关键词:

摘要: OBJECTIVES: Endoaortic balloon occlusion (EBO) and aortic transthoracic clamping (TTC) are the dominant methods of remote access perfusion (RAP) in minimally invasive cardiac surgery. The aim study was to compare two terms feasibility, success complications. METHODS: From June 2001 November 2011, 307 (median age; range) (57; 16–77 years) 460 (62; 11–88 patients underwent CABG, ASD mitral valve surgery using EBO TTC, respectively. Perioperative procedure postoperative complications were recorded. RESULTS: Overall 30-day mortality 0 2 (0.43%) for TTC groups, respectively (P = 0.52). RAP-associated conversions noted 21 (6.8%) 4 (1.3%) 9 (2%) 6 groups < 0.001, P 1.00, respectively). Incidence major complications, including dissection, vessel perforation, injury intrapericardial structures, limb ischaemia, myocardial infarction neurologic events, similar [EBO: 12 (4%); TTC: 11 (2.4%); 0.23]. Minor such as minor injury, groin bleeding or lymphatic fistula 31 (10.1%) 35 (7.6%), 0.23). Successful RAP procedures defined absence equal 295 (96%); 449 (97.6%); Complications detected during follow-up included pain: 30 249 (12%) 13 279 (4.7%) 0.002); sensational disturbances: 60 (24.1%) 40 278 (14.4%) 0.005) wound-healing complications: 49 (19.7%) 42 277 (15.2%) 0.172) CONCLUSIONS: can be successfully safely implemented ascending aorta performing equally feasibility procedural success.

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