Department of Cardiovascular Surgery, Japanese Red Cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan.
Department of Clinical Engineering, Japanese Red Cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan.
Gen Thorac Cardiovasc Surg. 2021 Aug;69(8):1271-1273. doi: 10.1007/s11748-021-01658-6. Epub 2021 Jun 19.
Gaining bloodless field in minimally invasive mitral valve surgery is crucial for a successful surgery. We here demonstrate a simple method to obtain bloodless field in minimally invasive mitral valve surgery with only single venous cannula through the femoral vein. A dual-stage venous cannula is inserted through the femoral vein, with its tip located deep in superior vena cava. After establishing full flow, the inferior vena cava (IVC) was snared. Returning blood from the IVC was blocked at the snare, and drained through the side holes at the midportion of the cannula. This technique collapsed the right atrium, and made the left atrium almost bloodless. Pressures of the femoral vein measured in 28 patients were 9.5 ± 4.1 mmHg before bypass, 6.8 ± 4.8 mmHg before snaring IVC, and 7.2 ± 4.8 mmHg after snaring. By blocking returning blood from the lower body, venous congestion of the lower body did not occur.
在微创二尖瓣手术中获得无血手术野对于手术的成功至关重要。我们在此展示了一种通过股静脉插入单根静脉插管即可在微创二尖瓣手术中获得无血手术野的简单方法。将双腔静脉插管通过股静脉插入，其尖端位于上腔静脉深处。建立完全血流后，用套扎环套扎下腔静脉。从下腔静脉回流的血液被套扎环阻断，并通过插管中段的侧孔排出。该技术使右心房塌陷，使左心房几乎无血。在 28 例患者中测量的股静脉压力在体外循环前为 9.5±4.1mmHg，在套扎下腔静脉前为 6.8±4.8mmHg，在套扎后为 7.2±4.8mmHg。通过阻断从下半身回流的血液，下半身的静脉淤血没有发生。
