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

研究成果: Article査読

7 被引用数 (Scopus)

抄録

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.

本文言語English
ページ(範囲)131-137
ページ数7
ジャーナルGeneral thoracic and cardiovascular surgery
64
3
DOI
出版ステータスPublished - 2016 3 1

ASJC Scopus subject areas

  • 外科
  • 呼吸器内科
  • 循環器および心血管医学

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