Safety and Applicability of Continuous Retrograde Cardioplegia in Minimally Invasive Aortic Valve Replacement: New Approaches.

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Annals of Thoracic and Cardiovascular Surgery Pub Date : 2022-02-20 Epub Date: 2021-08-04 DOI:10.5761/atcs.nm.20-00293

Shunsuke Sato, Takashi Azami, Tatsuya Kawamoto, Kyozo Inoue, Kenji Okada

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Abstract

Purpose: To discuss minimally invasive cardiac surgery aortic valve replacement (MICS-AVR) approach via anterior thoracotomy using continuous retrograde cardioplegia. Continuous retrograde cardioplegia facilitates excellent continuous homogeneous cooling of the heart during cardiac arrest.

Methods: We performed AVR using the proposed method in nine patients between June 2018 and September 2019. The median age of the patients was 73 (range: 43-84) years. The pleural space was entered via anterior thoracotomy. After opening of the right atrium, a retrograde cardioplegic cannula was inserted into the coronary sinus with a purse-string suture. Continuous cold blood retrograde cardioplegia was initiated at 700 mL/h.

Results: Extubation in the operating room was performed in five (56%) patients. No new decreased function of the left and right ventricles was observed in intraoperative transesophageal echography or transthoracic echocardiogram.

Conclusion: MICA-AVR through continuous retrograde cardioplegia is a safe technique.

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持续逆行心脏停搏术在微创主动脉瓣置换术中的安全性和适用性:新方法。

目的:探讨连续逆行心脏截瘫经前开胸的微创心脏手术主动脉瓣置换术(MICS-AVR)。在心脏骤停期间，持续逆行心脏骤停有利于心脏的持续均匀冷却。方法:我们于2018年6月至2019年9月对9例患者进行了AVR。患者的中位年龄为73岁(43-84岁)。胸膜间隙通过前开胸进入。打开右心房后，用荷包缝合将逆行心脏截瘫插管插入冠状窦。700 mL/h开始持续低温逆行心脏骤停。结果:5例(56%)患者在手术室拔管。术中经食管超声和经胸超声心动图未见新的左、右心室功能下降。结论:MICA-AVR经持续逆行心脏骤停是一种安全的技术。

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