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

• Published in: Annals of Thoracic and Cardiovascular Surgery Vol. 28; no. 1; pp. 36 - 40
• Main Authors: Sato, Shunsuke, Azami, Takashi, Kawamoto, Tatsuya, Inoue, Kyozo, Okada, Kenji
• Format: Journal Article
• Language: English
• Published: Japan The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery 01.01.2022
• Subjects: Adult; Aged; Aged, 80 and over; Aortic Valve - diagnostic imaging; Aortic Valve - surgery; Heart Arrest, Induced - adverse effects; Heart Arrest, Induced - methods; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation - adverse effects; Heart Valve Prosthesis Implantation - methods; Humans; inferior vena cava; Middle Aged; minimally invasive cardiac surgery aortic valve replacement; Minimally Invasive Surgical Procedures; New Methods; superior vena cava; Treatment Outcome; minimally invasive cardiac surgery aortic valve replacement; superior vena cava; inferior vena cava
• ISSN: 1341-1098; 2186-1005
• DOI: 10.5761/atcs.nm.20-00293

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.