Endovascular Aortic Balloon Clamp Malposition during Minimally Invasive Cardiac Surgery

MINIMALLY invasive cardiac surgery for coronary artery bypass grafting (CABG) and cardiac valve repair or replacement is a rapidly expanding field in cardiothoracic surgery. 1-3 Although it offers potential advantages to the patient and the healthcare system, including improved cosmetic results, reduced pain, shorter hospital stays, and an earlier return to normal activity, 4 it is not without its own risks. We report a case of a temporary reduction in cerebral perfusion, detected by transcranial Doppler (TCD), resulting from endovascular aortic balloon clamp malposition during minimally invasive mitral valve surgery. Monitoring strategies to detect endoaortic clamp malposition are discussed.