International Society For Minimally Invasive Cardiothoracic Surgery

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An Adjunct For Central Venous Cannulation In Minimally Invasive Cardiac Surgery
Vasily I. Kaleda1, Anatoly V. Molochkov1, Ivan A. Alekseev1, Vladimir V. Murylev1, Sergey Yu. Boldyrev2.
1Central Clinical Hospital, Moscow, Russian Federation, 2Ochapowski Regional Hospital #1, Krasnodar, Russian Federation.

BACKGROUND: Our aim is to describe our method of central venous cannulation in minimally invasive cardiac surgery using a novel device which facilitates easy tunneling of the venous cannula. METHODS: Our technique includes using a standard double-stage venous cannula with a 3/8" connection site. After completing ministernotomy pericardiotomy is performed and aorta is cannulated using the Seldinger technique. Direct right atrial cannulation is performed in a conventional fashion. Afterward, our device* (Fig. 1) is connected to the back end of the venous cannula. Then a strong thread is sewn to the tip of the device. A 2.5-cm incision is performed in the 5-6th intercostal space. Pulling the thread with a clamp the cannula is guided through the intercostal space out of the chest. RESULTS: Comparing with existing approaches, our technique has several advantages. Firstly, it frees the wound from the cannula making it more comfortable for a surgeon than conventional central venous cannulation. Also, it provides a better exposition of the aortic root. In addition, it does not require an additional groin access and thus helps to avoid complexity and local complications of femoral cannulation. CONCLUSIONS: The device enables safe, fast and convenient central venous cannulation for minimally invasive cardiac surgery. *Non-FDA approved. Patent pending.

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