Comparison of venous cannulation strategies in minimally invasive direct coronary artery bypass surgery
Öz
Purpose: This study aimed to quantitatively compare the efficacy of venous drainage and the requirements for vacuum-assisted venous drainage (VAVD) between bicaval and multistage femoral venous cannulation strategies in minimally invasive direct coronary artery bypass (MIDCAB).
Materials and Methods: In this retrospective, single-center study, 60 patients who underwent MIDCAB between 2018 and 2024 were analyzed. Thirty patients received bicaval cannulation via the right internal jugular and femoral veins (Group 1), while 30 patients underwent single cannulation using a multistage femoral venous cannula (Group 2). Primary outcomes included venous reservoir volume at the initiation of cardiopulmonary bypass (CPB) and the need for VAVD. Secondary outcomes comprised CPB duration and major postoperative complications.
Results: Mean pump flow rate was comparable between groups (Group 1: 4.5 ± 0.4 L/min vs. Group 2: 4.3 ± 0.5 L/min). However, mean initial venous reservoir volume was greater in Group 1 (824 ± 124 mL vs. 641 ± 95 mL). The requirement for VAVD was more frequent in Group 2 (82.7% vs. 24.1%). Additionally, CPB duration was longer in Group 2 (191.9 ± 24.4 min vs. 149.6 ± 39.6 min). No major postoperative complications were observed in either group.
Conclusion: Multistage femoral venous cannulation was associated with inferior venous drainage, necessitating more frequent vacuum support and resulting in prolonged CPB times. Bicaval cannulation may therefore provide a more reliable approach to achieving optimal surgical conditions in MIDCAB.
Anahtar Kelimeler
Bicaval venous cannulation, multistage single venous cannulation, vacuum, minimally invasive direct coronary artery bypass
Kaynakça
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