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Compulsory drainage of inferior vena cava to obtain bloodless field in minimally invasive mitral valve surgery

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Abstract

Gaining bloodless field in minimally invasive mitral valve surgery is crucial for a successful surgery. We here demonstrate a simple method to obtain bloodless field in minimally invasive mitral valve surgery with only single venous cannula through the femoral vein. A dual-stage venous cannula is inserted through the femoral vein, with its tip located deep in superior vena cava. After establishing full flow, the inferior vena cava (IVC) was snared. Returning blood from the IVC was blocked at the snare, and drained through the side holes at the midportion of the cannula. This technique collapsed the right atrium, and made the left atrium almost bloodless. Pressures of the femoral vein measured in 28 patients were 9.5 ± 4.1 mmHg before bypass, 6.8 ± 4.8 mmHg before snaring IVC, and 7.2 ± 4.8 mmHg after snaring. By blocking returning blood from the lower body, venous congestion of the lower body did not occur.

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, Japanese Red Cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan

    Toshiaki Ito

  2. Department of Clinical Engineering, Japanese Red Cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan

    Akitomo Hachisuka, Yuji Nakai & Masahiro Hiraki

Authors
  1. Toshiaki Ito
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  2. Akitomo Hachisuka
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  3. Yuji Nakai
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  4. Masahiro Hiraki
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Correspondence to Toshiaki Ito.

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Supplementary file1 (MP4 74776 KB) Video 1. After snaring inferior vena cava, the right atrium gradually collapsed. See the bloodless field of the left atrium and the mitral valve. The video is edited at twice the speed.

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Ito, T., Hachisuka, A., Nakai, Y. et al. Compulsory drainage of inferior vena cava to obtain bloodless field in minimally invasive mitral valve surgery. Gen Thorac Cardiovasc Surg 69, 1271–1273 (2021). https://doi.org/10.1007/s11748-021-01658-6

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  • DOI: https://doi.org/10.1007/s11748-021-01658-6

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