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Imaging and monitoring in minimally invasive valve surgery using an intra-aortic occlusion device: a single center experience
Imaging and monitoring in minimally invasive valve surgery using an intra-aortic occlusion device: a single center experience
- Source :
- J Thorac Dis
- Publication Year :
- 2021
- Publisher :
- AME Publishing Company, 2021.
-
Abstract
- BACKGROUND: Minimally invasive approach through a right mini-thoracotomy is a world-wide used procedure for mitral valve surgery. We performed a retrospective analysis based on our center experience in order to propose an effective, safe and reproducible method using an intra-aortic occlusion device. METHODS: This is a retrospective analysis on 48 consecutive patients undergoing mitral valve surgery through a right anterolateral mini-thoracotomy in our center. An intra-aortic occlusion device was used for aortic clamping and cardioplegia delivery. Simultaneous multi-plane three-dimensional echocardiography imaging was acquired to detect the venous cannulas position, the intra-aortic device location in the ascending aorta, the balloon inflation, the complete occlusion of the aorta, the cardioplegia delivery, the origin and the blood flow in the right coronary artery. Aortic root pressure was measured by the tip of the intra-aortic occlusion device. A bilateral upper extremity invasive arterial pressure monitoring was detected. Neuromonitoring was performed through bilateral cerebral oximetry. RESULTS: The analysis has shown no aortic dissection, neurological damage type 1 and myocardial ischemia in the study population. In 3 cases a distal displacement of the intra-aortic occlusion device was promptly detected by the combined use of echocardiographic imaging and by a drop of the right cerebral oximetry saturation and of the right radial artery pressure. CONCLUSIONS: The combined use of transesophageal simultaneous multi-plane three- dimensional echocardiography imaging, bilateral upper extremity invasive arterial pressure monitoring, aortic root pressure and cerebral oximetry is an effective, safe and reproducible method in patients undergoing minimally invasive valve surgery using an intra-aortic occlusion device.
- Subjects :
- Pulmonary and Respiratory Medicine
medicine.medical_specialty
Valve surgery
030204 cardiovascular system & hematology
three dimensional echocardiography
Single Center
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine.artery
Occlusion
Ascending aorta
medicine
Aortic dissection
Aorta
business.industry
Minimally invasive approach
intra-aortic occlusion device
Blood flow
medicine.disease
Settore MED/23
030228 respiratory system
Right coronary artery
Cardiology
cardiovascular system
Original Article
business
mitral valve surgery
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- J Thorac Dis
- Accession number :
- edsair.doi.dedup.....9e326273ed42be20a55050f8eeaf0ecf