Axillary Artery Access for Combined Endoaortic Balloon Occlusion and Perfusion during Robotic Mitral Valve Surgery

We aimed to develop a method that provides an alternative cannulation site in robotic mitral valve surgery that allows simultaneous endo-occlusion and antegrade perfusion. A 71-year-old man with severe mitral regurgitation and history of coronary artery bypass grafting underwent totally endoscopic r...

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Bibliographic Details
Published in:Innovations (Philadelphia, Pa.) Pa.), 2016-05, Vol.11 (3), p.217-218
Main Authors: Ambur, Vishnu V., Kadakia, Sagar S., Taghavi, Sharven, Jayarajan, Senthil N., Kashem, Mohammed Abul, McCarthy, James, Shiose, Akira, Wheatley, Grayson H., Toyoda, Yoshiya, Guy, T. Sloane
Format: Article
Language:English
Subjects:
Aged
Axillary Artery - surgery
Balloon Occlusion - methods
Combined Modality Therapy
Echocardiography, Transesophageal
Heart Valve Prosthesis Implantation - methods
Humans
Male
Mitral Valve Insufficiency - diagnostic imaging
Mitral Valve Insufficiency - therapy
Perfusion - methods
Robotic Surgical Procedures - methods
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Summary:We aimed to develop a method that provides an alternative cannulation site in robotic mitral valve surgery that allows simultaneous endo-occlusion and antegrade perfusion. A 71-year-old man with severe mitral regurgitation and history of coronary artery bypass grafting underwent totally endoscopic robotic mitral valve repair. A 23-mm endoreturn cannula was placed through a 10-mm graft that was sewn to the left axillary artery. An endoballoon was passed through the Dacron/cannula complex and into the ascending aorta. This complex was used for simultaneous antegrade perfusion, endoballoon occlusion, and antegrade cardioplegia. Completion transesophageal echocardiography showed no evidence of mitral regurgitation. The patient had an uneventful postoperative course and was doing well at his 2-month follow-up appointment. The left axillary artery is a viable option for simultaneous endoballoon occlusion, antegrade perfusion, and antegrade cardioplegia in robotic mitral valve surgery. This has the potential benefit of providing antegrade perfusion, which some studies have shown to be associated with a decreased risk of complications when compared with retrograde perfusion specifically inpatients with severe peripheral vascular disease.
ISSN:1556-9845
1559-0879
DOI:10.1097/imi.0000000000000251