Double venous drainage through vena cava superior in upper ministernotomy and right minithoracotomy approaches for aortic valve replacement facilitate the operation

Abstract

Methods 236 patients were included in our study, to whom aortic valve was replaced. The purpose of this study was to examine the potential benefit of double venous cannulation through superior vena cava (SVC) for venous drainage for aortic valve replacement (AVR) in upper mini-sternotomy and right mini-thoracotomy approaches. Five to 7 cm skin incision was made at the level of third intercostal space, through which the pericardium was opened longitudinally. Shortly after the patient was fully heparinized, venous drainage was achieved by vacuum assisted (40-60 mmHg) double venous cannulation through SVC (22 French) while arterial return was established by right femoral artery or ascending aorta (standard arterial cannula. We cross-clamped the aorta and infused antegrade cold blood cardioplegia into the ascending aorta and retrograde cold blood cardioplegia into the coronary sinus to achieve cardiac arrest. The aortic valve was approached through a transverse aortotomy. The native valve was removed completely and replaced with biological or mechanical valve, secured by Teflon pledges and sutures.