Transaortic endoclamp for mitral valve operation through right minithoracotomy in 369 patients.

Published

Journal Article

OBJECTIVE: : The effects and benefits of a transaortic endoclamp for mitral valve operation through right minithoracotomy have not been established. METHODS: : The records were examined in 671 patients undergoing mitral valve operation using aortic cannulation through a 6-cm right minithoracotomy in the fourth intercostal space. The ascending aorta was cannulated with a 24-Fr cannula through a 12-mm port in the first intercostal space. The experience from 1998 to 2006 with aortic endoclamping (group A, N = 436) was compared with the experience from 2006 to 2009 with external aortic clamping (group B, N = 235). Aortic endoclamping was achieved with a 30 mL endoclamp introduced through the aortic cannula into the ascending aorta to provide aortic endoclamping, anterograde cardioplegia, and root venting. Percutaneous femoral venous cannulation was used. RESULTS: : Group A and group B had similar demographics. Endoclamp availability (group A) resulted in significantly less fibrillatory arrest (no clamping) in 67 of 436 (15%) versus 104 of 235 (44%) patients in group B (P = 0.001). In patients with aortic clamping, endoclamp (group A) versus external clamp (group B) was not a determinant of clamp time or pump time. Hospital and late outcomes were not different between groups. No patient complications could be attributed to the endoclamp. CONCLUSIONS: : Aortic endoclamping requires no more clamp or pump time than external clamping and can provide a more bloodless field than ventricular fibrillation without obstructing hardware. Aortic endoclamping is a safe alternative for mitral surgery through right minithoracotomy.

Full Text

Duke Authors

Cited Authors

  • Glower, DD; Desai, B

Published Date

  • November 2010

Published In

Volume / Issue

  • 5 / 6

Start / End Page

  • 394 - 399

PubMed ID

  • 22437633

Pubmed Central ID

  • 22437633

International Standard Serial Number (ISSN)

  • 1556-9845

Digital Object Identifier (DOI)

  • 10.1097/IMI.0b013e31820290d5

Language

  • eng

Conference Location

  • United States