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Acute limb ischemia after minimally invasive cardiac surgery using the ProGlide:A case series

World Journal of Clinical Cases 2022年第35期10卷 13052-13057页

作者： Jonggeun Lee Up Huh Seunghwan Song Chung Won Lee Department of Thoracic and Cardiovascular surgery Pusan National University School of MedicineBiomedical Research InstitutePusan National University HospitalBusan 49241South Korea

BACKGROUND We report two cases of acute femoral artery occlusion following the use of ProGlide in minimally invasive cardiac surgery and insertion of large-bore catheters through the common femoral artery.This will add to the existing body of literature by highlighting the possible complications associated with the use of ProGlide and reiterate that the use of the sono-guided ProGlide skill will reduce the incidence of these complications.CASE SUMMARY A 78-year-old man underwent minimally invasive cardiac surgery for severe aortic valve stenosis.After the operation,the puncture site of the common femoral artery was closed using ProGlide.The next morning,after regaining consciousness,he complained of pain,motor weakness(grade 2),and coldness in the right lower extremity.A 65-year-old man underwent minimally invasive cardiac surgery for a large secundum atrial septal defect(5 cm×5 cm).After the operation,the puncture site of the common femoral artery was closed using ProGlide.After extubation,the patient complained of paresthesia of the right thigh.Both the patients underwent emergency surgery for acute occlusion of the common femoral artery.CONCLUSION If the sono-guided ProGlide skill is used,complications can be prevented,and ProGlide can be safely used.

关键词： ProGlide Acute common femoral artery occlusion minimal invasive cardiac surgery Sono-guided Femoral artery stenosis Case report

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Hundred plus minimally Access cardiac surgery: Our Experience

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World Journal of Cardiovascular surgery 2022年第10期12卷 256-263页

作者： Anil Bhattarai Arjun Gurung Prabhat Khakural Ravi Baral Bhagawan Koirala Department of Cardiothoracic and Vascular surgery Tribhuvan University Manmohan Cardiothoracic Vascular and Transplant Center Kathmandu Nepal Department of Cardiothoracic & Vascular Anesthesiology Tribhuvan University Manmohan Cardiothoracic Vascular and Transplant Center Kathmandu Nepal

Background: minimally invasive procedures lead to less scarring resulting in better cosmetic outcomes. This has resulted in increased patient interest in such procedures and this has motivated surgeons to pursue newer and improved techniques for minimally invasive cardiac surgery (MICS). Obviously, with the advent of MICS the techniques to achieve it also needed to be changed and upgraded which includes access for cannulation for cardiopulmonary bypass (CPB). Right internal jugular vein percutaneous cannulation, together with the direct surgical cannulation of femoral vessels with minithoracotomy/ministernotomy proves to be a safe and effective tool in patients with body weight of above 20 kg for minimally access cardiac surgery. We use this technique for Atrial septal defect (ASD) closure, aortic valve replacement (AVR), redo Tricuspid valve replacement (TVR) and mitral valve replacement (MVR). Here, we describe our experience with minimally invasive approach using total peripheral cannulation and an anterior mini-thoracotomy (6 cm or less) incision for ASD closure, AVR, TVR and MVR. Methods: The preoperative variables, intraoperative data and postoperative outcomes of patients undergoing minimally invasive ASD closure, AVR, TVR and MVR with total peripheral cannulation were collected and analyzed. Results: Between May 2014 to May 2019 we performed minimally invasive closure of atrial septal defects, AVR, TVR and MVR with total peripheral cannulation in 103 patients. There were 64 females and 39 males Mean age was 25 years (range 8 - 58 years), Spectrum of procedures include ASD closure in 81 patients (78.6%), AVR via minithoracotomy in 13 patients (12.6%) and AVR via ministernotomy in 3 patients (2.9%), redo TVR in 5 (4.8%), MVR in 1 patient (0.97%). Average cardiopulmonary bypass (CPB) time was 46 minutes (range 22 - 78 min) and average aortic cross-clamp time (AoX) 26 min (range 12 - 45 min) in ASD closure group. In AVR group average CPB time was 91 min (range 72 - 120 min) and AoX time 76.5 min (range 65 - 1

关键词： minimal invasive cardiac surgery Cosmetic Outcome Total Peripheral Cannulation

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