Scohy TV1*, van Kerckhoven G1, Bentala M2, Bramer S2, Laboutv JAM2 and Gerritse BM1
1Department of Anaesthesiology and Intensive Care, Amphia Hospital, Netherlands
2Department of Cardiothoracic Surgery, Amphia Hospital, Netherlands
Introduction: One of the main obstacles of minimally invasive surgery for Aortic Valve Replacement (M-AVR) is the increased Cardiopulmonary Bypass (CPB) and aortic cross-clamping time. We Hypothesize that the use of a percutaneous coronary sinus catheterto deliver retrograde cardioplegia may facilitate surgery and reduce CPB- and aortic cross-clamping time.Methods: Data were collected prospectively at the Amphia Hospital, Breda, and the Netherlands from May 2014 to May 2016 and were analysed retrospectively. A total of 40 M-AVR patients were included. In all cases warm blood cardioplegia was used. The initial dose of cardioplegia was administered antegradely through the aortic root in all 40 patients. In all patients cardioplegia was repeated each 20 min. Patients with a percutaneous coronary sinus catheter received their following doses of cardioplegia retrogradely, whereas patients without a coronary sinus catheter received cardioplegia selectively through the coronary ostia.Results: 23 patients received retrograde cardioplegia through a percutaneous coronary sinus catheter versus 17 patients that received their cardioplegia solely antegradely. Mean aortic crossclamp time was significantly shorter in the percutaneous coronary sinus catheter group (63 ± 11 vs. 55 ± 12, p=0.045).The mean CPB time was 8 minutes shorter in the percutaneous coronary sinus catheter group, although this was not significant (82 min ± 14 vs. 74 min ± 14, p=0.075). Maximum Troponin T did not differ significantly between the two groups (0.12 [0.08] vs. 0.13 [0.11], p=0.227).Conclusion: Percutaneous retrograde cardioplegia administered through a coronary sinus catheterin minimal invasive AVR reduces aortic cross-clamping time significantly.
Retrograde cardioplegia; Minimally invasive surgery aortic valve replacement; Percutaneous coronary sinus catheter
Scohy TV, van Kerckhoven G, Bentala M, Bramer S, Laboutv JAM, Gerritse BM. Percutaneous Retrograde Cardioplegia in Minimal Access Aortic Valve Replacement Reduces Aortic Cross-Clamping Time Significantly. Clin Surg. 2017; 2: 1796.