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Pacing Swan-Ganz Catheter in Minimally Invasive Mitral Valve Surgery
- Source :
- Revista Argentina de Cardiologia. 87:357-362
- Publication Year :
- 2019
- Publisher :
- Revista Argentina de Cardiologia, 2019.
-
Abstract
- espanolIntroduccion: La cirugia mediante mini-toracotomia lateral presenta ventajas comparativas sobre el acceso convencional comomenor trauma quirurgico, reducida morbimortalidad y un resultado estetico superior, pero plantea dificultades en caso denecesitar estimulacion electrica temporal.Objetivo: Valorar el empleo terapeutico del cateter de Swan-Ganz con marcapasos incorporado como solucion a dicho problemay analizar sus complicaciones.Material y metodos: Se incluyeron pacientes programados para cirugia mini-invasiva mitral mediante mini-toracotomia lateral.Se definio empleo terapeutico del cateter al uso debido a bradiarritmias o trastornos de conduccion o necesidad de incrementarla frecuencia cardiaca con fines hemodinamicos. Pacientes intervenidos de urgencia o emergencia, fueron excluidos del estudio.Resultados: Fueron incluidos 517 pacientes (289 de sexo masculino, con edad promedio de 68,3 ± 10,4 anos); se efectuaron 115(22,2%) reemplazos y 402 (77,7%) plasticas mitrales. Simultaneamente, se realizaron 294 (56,9%) procedimientos de Maze, 182(35,2%) cierres de orejuela izquierda, 9 (1,7%) cierres de defectos septales y 14 (2,7%) plasticas tricuspideas. Ciento sesenta ydos (313%) pacientes necesitaron ser marcapaseados; debido a bradiarritmias, 85 (52,47%) pacientes; por trastornos de conduccion,50 (30,86%) pacientes; mientras que otros 27 (16,66%) requirieron incrementar su frecuencia debido a bajo volumenminuto. La mortalidad resulto de 12 (2,32%) casos. Catorce (2,7%) pacientes presentaron perdida de captura y se resolvieroncon el reposicionamiento del cateter, mientras que 2 (0,6%) pacientes presentaron atrapamiento y requirieron reintervencion.Conclusiones: Casi un tercio de los pacientes intervenidos mediante mini-toracotomia lateral requirieron del empleo terapeuticodel cateter de Swan-Ganz con marcapasos. Dos pacientes presentaron atrapamiento y requirieron resolucion quirurgica. EnglishThe use of a lateral mini-thoracotomy presents several advantages over the standard access, such as less surgical trauma, reduced morbidity and mortality, shorter recovery time and better cosmetic results, but presents difficulties iftemporary pacing is required.Objective: The aim of this study was to evaluate the therapeutic use of a Swan-Ganz catheter with pacing capabilities andanalyze its complications.Methods: Patients undergoing scheduled minimally invasive mitral valve surgery through lateral mini-thoracotomy wereincluded in the study. Therapeutic use of the pacing catheter was defined as the need for pacing due to bradyarrhythmiasor conduction disorders or need of increasing heart rate in case of hemodynamic instability. Patients undergoing urgent oremergency surgery were excluded from the study.Results: A total of 517 patients were included in the study; mean age was 68.3 ± 10.4 years and 289 (55.9%) were men; 115 patients(22.2%) underwent mitral valve replacement and 402 (77.7%) mitral valve repair. The following concomitant procedureswere carried out: 294 (56.9%) Maze procedures, 182 (35.2%) left atrial appendage closures, 9 (1.7%) atrial septal defect closuresand 14 (2.7%) tricuspid valve repair surgeries. In the postoperative period 162 (31.3%) patients required pacing due to bradyarrhythmiasin 85 cases (52.47%), conduction disorders in 50 (30.86%), and need to increase heart rate in 27 (16.66%) patientswith low cardiac output syndrome. Postoperative mortality was 2.32% (n=12). Fourteen (2.7%) patients presented loss of capturethat was resolved with catheter repositioning, while 2 (0.6%) patients presented catheter entrapment requiring reintervention.Conclusion: Almost one-third of the patients undergoing lateral mini-thoracotomy required therapeutic use of the pacingSwan-Ganz catheter. Two patients presented catheter entrapment and required surgical reintervention
Details
- Volume :
- 87
- Database :
- OpenAIRE
- Journal :
- Revista Argentina de Cardiologia
- Accession number :
- edsair.doi...........6d091a7d1b09b944009051a36b345d85
- Full Text :
- https://doi.org/10.7775/rac.v87.i5.15807