Abstract
BackgroundClinical application of minimally invasive cardiac surgery has increased annually. Cardiopulmonary bypass is established by peripheral cannulation during minimally invasive cardiac surgery. The methodology of peripheral cannulation has unique characteristics, which have associated risks and complications. Few studies have been conducted on this topic. In this study, we focused on complications of peripheral cannulation in totally endoscopic cardiac surgery.MethodsPatients who underwent totally endoscopic cardiac surgery with cardiopulmonary bypass established by peripheral cannulation at our institution between January 2019 and June 2020 were reviewed. Specific cannulation strategies and related cannulation complications were noted.ResultsOne hundred forty-eight patients underwent totally endoscopic cardiac surgery. One hundred forty-eight cannulations were performed in the femoral artery and vein, and eleven were performed in the internal jugular vein (combined with the femoral vein). The median size of the femoral artery cannula was 22Fr, and that of the venous canula was 24Fr. One patient died of retroperitoneal haematoma due to femoral artery injury. Three patients had postoperative lower limb oedema. One patient had a postoperative diagnosis of femoral vein thrombosis.ConclusionsDifferent from cannulation in patients with aortic dissection and aneurysms, femoral artery cannulation is safe in totally endoscopic cardiac surgery. Venous cannulation is characterized by a large-bore venous cannula and a short period of use. There are few reports about complications of venous cannulation. The main complication in this study was mechanical injury, and the key to preventing this injury is meticulous manipulation during surgery.
Highlights
In recent years, minimally invasive surgery has been rapidly adopted in the field of cardiothoracic surgery due to its advantages of reducing surgical trauma and promoting rapid recovery [1,2,3]
We conducted a review of the literature and found that few articles have examined the complications of cannulation in totally endoscopic cardiac surgery
Patients selection From January 2019 to June 2020, one hundred forty-eight patients underwent totally endoscopic cardiac surgery with cardiopulmonary bypass (CPB) establishment through peripheral cannulation and constitute the study population
Summary
Minimally invasive surgery has been rapidly adopted in the field of cardiothoracic surgery due to its advantages of reducing surgical trauma and promoting rapid recovery [1,2,3]. We conducted a review of the literature and found that few articles have examined the complications of cannulation in totally endoscopic cardiac surgery. There is no literature focused on complications after venous cannulation in totally endoscopic cardiac surgery, so it is clinically relevant to conduct the present study. This study is a single-centre experience of totally endoscopic cardiac surgery, with analysis focused on complications related to peripheral cannulation. It is not a comparative study aimed at the complications of different cannulation sites but rather a specific look at a large cohort that received peripheral cannulation during MICS, with the purpose of determining the level of safety and the related complications. Cardiopulmonary bypass is established by peripheral cannulation during minimally invasive cardiac surgery. We focused on complications of peripheral cannulation in totally endoscopic cardiac surgery
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