Department of Cardiac Surgery, Children's Hospital Boston and Harvard Medical School, Boston, MA 02115, USA.
J Thorac Cardiovasc Surg. 2011 Dec;142(6):1545-51. doi: 10.1016/j.jtcvs.2011.07.041. Epub 2011 Sep 8.
Intracardiac beating-heart procedures require the introduction and exchange of complex instruments and devices. To prevent potential complications such as air embolism and bleeding, a universal cardioport was designed and tested.
The design consists of a port body and a series of interchangeable sleeves. The port uses a fluid purging system to remove air from the instrument before insertion into the heart, and a valve system minimizes blood loss during instrument changes.
The cardioport was tested ex vivo and in vivo in pigs (n = 5). Beating-heart procedures, such as septal defect closure and mitral valve repair, were modeled. Ex vivo trials (n = 150) were performed, and no air emboli were introduced using the port. In comparison, air emboli were detected in 40% to 85% of the cases without the use of the port-based purging system. Port operation revealed excellent ergonomics and minimal blood loss.
A novel cardioport system designed to prevent air entry and blood loss from transcardiac instrument introduction was shown to be an enabling platform for intracardiac beating-heart surgery. The port system improves safety and facilitates further development of complex instruments and devices for transcardiac beating-heart surgery.
心脏跳动时进行的手术需要引入和交换复杂的仪器和设备。为了防止空气栓塞和出血等潜在并发症,设计并测试了一种通用心端口。
该设计由一个端口体和一系列可互换的套管组成。该端口使用流体吹扫系统在将器械插入心脏之前清除器械中的空气,并且阀系统在器械更换期间最大限度地减少血液流失。
心端口在猪(n=5)中进行了离体和体内测试。模拟了心脏跳动时的手术,如间隔缺损闭合和二尖瓣修复。进行了离体试验(n=150),使用端口未引入空气栓塞。相比之下,在不使用基于端口的吹扫系统的情况下,40%至 85%的情况下检测到空气栓塞。端口操作显示出出色的人体工程学和最小的失血量。
设计用于防止经心器械引入时空气进入和失血的新型心端口系统被证明是心脏跳动时心脏内手术的一个可行平台。该端口系统提高了安全性,并为经心心脏跳动手术的复杂仪器和设备的进一步发展提供了便利。