Background- The minimally invasive extracorporeal circulation (MiECC) system was developed to minimize the contact of blood with air and foreign surfaces during conventional CPB. It is also aimed to reduce the inflammatory response by further increasing the biocompatibility of the components that make up the MiECC circuits. Surgical repair remains the best treatment for severe primary mitral regurgitation (MR). Minimally invasive mitral valve surgery is being increasingly performed, but there is a lack of solid evidence comparing thoracoscopic with conventional surgery. Combining the use of the MiECC technique with MIMVS could open up new research scenarios.
Methods- Although considerable progress has been made in the standardization of the surgical technique, limitations remain to be filled in the setting of Endo-cavitary aspiration for the association of MiECC with MIMVS. In perioperative practice and in scientific evidence, sump sucker is placed in the left pulmonary veins to keep the operative field clear and carbon dioxide is insufflated into the chest cavity to displace air. The sump aspirator is crucial for good vision and a clear surgical field however the suction of the pulmonary vein involves a discreet aspiration of air mixed with blood, this principle is far from being defined as being a controlled aspiration free from air typical of the management MiECC.
Results- . In this document we propose a conceptual device can allow the association of the MiECC with MIMVS. The device conceptually consists of a selective endo-cavitary aspiration system of the pulmonary veins closed to the air, which involves the inflation of four anchoring polymer balloons inside the pulmonary veins through a single manual filling line with the use physiological solution (principle of communicating vessels) integrated inside the endo-cavitary aspiration channel for extracorporeal circulation (Figure 1).
Conclusions-This closed suction system allows the use of MiECC techniques on mitral valve surgery, eliminating air-blood contact and consequently eliminating the pathophysiological alterations of conventional circuits.
