Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, 350001, China.
Fujian Key Laboratory of Cardio-thoracic Surgery (Fujian Medical University), Fuzhou, China.
J Cardiothorac Surg. 2021 Mar 20;16(1):38. doi: 10.1186/s13019-021-01417-x.
Clinical application of minimally invasive cardiac surgery has increased annually. Cardiopulmonary bypass is established by peripheral cannulation during minimally invasive cardiac surgery. The methodology of peripheral cannulation has unique characteristics, which have associated risks and complications. Few studies have been conducted on this topic. In this study, we focused on complications of peripheral cannulation in totally endoscopic cardiac surgery.
Patients who underwent totally endoscopic cardiac surgery with cardiopulmonary bypass established by peripheral cannulation at our institution between January 2019 and June 2020 were reviewed. Specific cannulation strategies and related cannulation complications were noted.
One hundred forty-eight patients underwent totally endoscopic cardiac surgery. One hundred forty-eight cannulations were performed in the femoral artery and vein, and eleven were performed in the internal jugular vein (combined with the femoral vein). The median size of the femoral artery cannula was 22Fr, and that of the venous canula was 24Fr. One patient died of retroperitoneal haematoma due to femoral artery injury. Three patients had postoperative lower limb oedema. One patient had a postoperative diagnosis of femoral vein thrombosis.
Different from cannulation in patients with aortic dissection and aneurysms, femoral artery cannulation is safe in totally endoscopic cardiac surgery. Venous cannulation is characterized by a large-bore venous cannula and a short period of use. There are few reports about complications of venous cannulation. The main complication in this study was mechanical injury, and the key to preventing this injury is meticulous manipulation during surgery.
微创心脏手术的临床应用逐年增加。微创心脏手术通过外周插管建立体外循环。外周插管的方法具有独特的特点，存在相关的风险和并发症。关于这个主题的研究很少。本研究重点关注全内镜心脏手术中外周插管的并发症。
回顾我院 2019 年 1 月至 2020 年 6 月期间通过外周插管行体外循环全内镜心脏手术的患者。记录了具体的插管策略和相关的插管并发症。
148 例患者接受了全内镜心脏手术。148 例在股动、静脉插管，11 例在颈内静脉（与股静脉联合）插管。股动脉插管的中位直径为 22Fr，静脉插管的中位直径为 24Fr。1 例患者因股动脉损伤导致腹膜后血肿死亡。3 例患者术后下肢水肿。1 例患者术后诊断为股静脉血栓形成。
与主动脉夹层和动脉瘤患者的插管不同，全内镜心脏手术中股动脉插管是安全的。静脉插管的特点是大口径静脉插管和使用时间短。关于静脉插管并发症的报道较少。本研究中的主要并发症是机械损伤，预防这种损伤的关键是手术过程中的精细操作。
