Virtually Wall-Less versus Standard Thin-Wall Venous Cannula in the Minimally Invasive Mitral Valve Surgery: Single-Center Experience
<i>Background and Objectives</i>: Minimally invasive cardiac surgery (MICS) has been developing since 1996. Peripheral cannulation is required to perform MICS, and good venous drainage and a bloodless field are crucial for the success of this procedure. We assessed the benefits of using...
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| Format: | Article |
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MDPI AG
2023-06-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/7/1221 |
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| author | Fabrizio Ceresa Liborio Francesco Mammana Aurora Leonardi Augusto Palermo Francesco Patanè |
| author_facet | Fabrizio Ceresa Liborio Francesco Mammana Aurora Leonardi Augusto Palermo Francesco Patanè |
| author_sort | Fabrizio Ceresa |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Minimally invasive cardiac surgery (MICS) has been developing since 1996. Peripheral cannulation is required to perform MICS, and good venous drainage and a bloodless field are crucial for the success of this procedure. We assessed the benefits of using a virtually wall-less cannula in comparison with the standard thin-wall cannula in clinical practice. <i>Materials and Methods</i>: Between January 2021 and December 2022, we evaluated 65 elective patients, who underwent isolated minimally invasive mitral valve surgery. Both the virtually wall-less and the thin-wall cannulas were placed through a surgical cut-down. Patients’ characteristics at baseline were similar in the two groups, except for the body surface area (BSA), which was greater in the virtually wall-less group compared to the thin-wall one. In the standard group, the size of the cannula was chosen depending on the patient’s BSA, and the choice of the Smartcannula was based on their height. <i>Results</i>: There were no significant differences between the two groups in terms of negative pressure applied, target flow achieved, hemolysis, the need for blood transfusion, and the post-operative increases in liver and renal enzymes. However, in all the patients, the estimated target flow was achieved, thereby showing the better hemodynamic performance of the virtually wall-less cannula, since, in this group, the patients’ BSA was significantly greater compared to the thin-wall group. Ultimately, the mean cross-clamp time, as an indirect index of the effectiveness of the venous drainage, is shorter in the virtually wall-less group compared with the thin-wall group. <i>Conclusions</i>: The virtually wall-less cannula should be preferred in minimally invasive mitral valve surgery due to its superior performance in terms of venous drainage compared with the standard thin-wall cannula. |
| first_indexed | 2024-03-11T00:51:08Z |
| format | Article |
| id | doaj.art-b8bc3f8b1fac4552b84b8b524b6c482e |
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| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-11T00:51:08Z |
| publishDate | 2023-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-b8bc3f8b1fac4552b84b8b524b6c482e2023-11-18T20:23:32ZengMDPI AGMedicina1010-660X1648-91442023-06-01597122110.3390/medicina59071221Virtually Wall-Less versus Standard Thin-Wall Venous Cannula in the Minimally Invasive Mitral Valve Surgery: Single-Center ExperienceFabrizio Ceresa0Liborio Francesco Mammana1Aurora Leonardi2Augusto Palermo3Francesco Patanè4Cardio-Vascular and Thoracic Department, Papardo Hospital, 98121 Messina, ItalyCardio-Vascular and Thoracic Department, Papardo Hospital, 98121 Messina, ItalyCardio-Vascular and Thoracic Department, Papardo Hospital, 98121 Messina, ItalyCardio-Vascular and Thoracic Department, Papardo Hospital, 98121 Messina, ItalyCardio-Vascular and Thoracic Department, Papardo Hospital, 98121 Messina, Italy<i>Background and Objectives</i>: Minimally invasive cardiac surgery (MICS) has been developing since 1996. Peripheral cannulation is required to perform MICS, and good venous drainage and a bloodless field are crucial for the success of this procedure. We assessed the benefits of using a virtually wall-less cannula in comparison with the standard thin-wall cannula in clinical practice. <i>Materials and Methods</i>: Between January 2021 and December 2022, we evaluated 65 elective patients, who underwent isolated minimally invasive mitral valve surgery. Both the virtually wall-less and the thin-wall cannulas were placed through a surgical cut-down. Patients’ characteristics at baseline were similar in the two groups, except for the body surface area (BSA), which was greater in the virtually wall-less group compared to the thin-wall one. In the standard group, the size of the cannula was chosen depending on the patient’s BSA, and the choice of the Smartcannula was based on their height. <i>Results</i>: There were no significant differences between the two groups in terms of negative pressure applied, target flow achieved, hemolysis, the need for blood transfusion, and the post-operative increases in liver and renal enzymes. However, in all the patients, the estimated target flow was achieved, thereby showing the better hemodynamic performance of the virtually wall-less cannula, since, in this group, the patients’ BSA was significantly greater compared to the thin-wall group. Ultimately, the mean cross-clamp time, as an indirect index of the effectiveness of the venous drainage, is shorter in the virtually wall-less group compared with the thin-wall group. <i>Conclusions</i>: The virtually wall-less cannula should be preferred in minimally invasive mitral valve surgery due to its superior performance in terms of venous drainage compared with the standard thin-wall cannula.https://www.mdpi.com/1648-9144/59/7/1221minimally invasive mitral valve surgeryvirtually wall-less cannula |
| spellingShingle | Fabrizio Ceresa Liborio Francesco Mammana Aurora Leonardi Augusto Palermo Francesco Patanè Virtually Wall-Less versus Standard Thin-Wall Venous Cannula in the Minimally Invasive Mitral Valve Surgery: Single-Center Experience Medicina minimally invasive mitral valve surgery virtually wall-less cannula |
| title | Virtually Wall-Less versus Standard Thin-Wall Venous Cannula in the Minimally Invasive Mitral Valve Surgery: Single-Center Experience |
| title_full | Virtually Wall-Less versus Standard Thin-Wall Venous Cannula in the Minimally Invasive Mitral Valve Surgery: Single-Center Experience |
| title_fullStr | Virtually Wall-Less versus Standard Thin-Wall Venous Cannula in the Minimally Invasive Mitral Valve Surgery: Single-Center Experience |
| title_full_unstemmed | Virtually Wall-Less versus Standard Thin-Wall Venous Cannula in the Minimally Invasive Mitral Valve Surgery: Single-Center Experience |
| title_short | Virtually Wall-Less versus Standard Thin-Wall Venous Cannula in the Minimally Invasive Mitral Valve Surgery: Single-Center Experience |
| title_sort | virtually wall less versus standard thin wall venous cannula in the minimally invasive mitral valve surgery single center experience |
| topic | minimally invasive mitral valve surgery virtually wall-less cannula |
| url | https://www.mdpi.com/1648-9144/59/7/1221 |
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