Alternative peripheral perfusion strategies for safe cardiopulmonary bypass in atrial septal defect closure via a right minithoracotomy approach

Hiroto Kitahara, Kazuma Okamoto, Mikihiko Kudo, Akihiro Yoshitake, Takahito Ito, Kanako Hayashi, Yu Inaba, Yuta Akamatsu, Hideyuki Shimizu

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objectives: In cases of cardiac surgery via a minimally invasive right minithoracotomy approach, cardiopulmonary bypass is established with peripheral arterial cannulation, frequently with a single femoral artery. Occasionally, alternative perfusion access is required to prevent perfusion site-related complications. In this study, the feasibility of alternative perfusion strategies was verified by comparing the postoperative outcomes and complications. Methods: The records of 91 consecutive patients (68 women, 23 men; mean age 40.7 ± 16.5 years) who underwent atrial septal defect (ASD) closure via a right minithoracotomy approach between January 2009 and September 2014 were reviewed. Patients were divided into two groups: those with single femoral arterial access (SF group, n = 84), and those with alternative perfusion access (ALT group, n = 7, bilateral femoral arterial cannulation in 6, side-arm graft anastomosed to the femoral artery in 1). Results: Femoral artery diameter was smaller in the ALT group than in the SF group (6.5 ± 0.5 vs. 7.3 ± 1.0 mm, P = 0.013). Operating time was longer in the ALT group than in the SF group (259.2 ± 54.0 vs. 208.3 ± 54.9 min, P = 0.031). One patient was converted to ascending aortic cannulation owing to high perfusion pressure. Postoperative major cardiac or cerebrovascular events, such as death, stroke, or myocardial infarction, did not occur in either group. Conclusions: Alternative perfusion access was safe in ASD closure via a right minithoracotomy approach. Precise preoperative evaluation of the iliofemoral artery is important for choosing the appropriate perfusion strategy.

Original languageEnglish
Pages (from-to)131-137
Number of pages7
JournalGeneral thoracic and cardiovascular surgery
Volume64
Issue number3
DOIs
Publication statusPublished - 2016 Mar 1

Keywords

  • Cardiopulmonary bypass
  • Congenital heart disease
  • Minimally invasive surgery

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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