Monitoring aspects during port-access cardiac surgery

P. Ceriana, A. Pagnin, A. Locatelli, M. Maurelli, G. Minzioni, P. Spreafico, A. Degani, M. Vigano

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective. To report the experience gained at our Cardiosurgical Centre with the recently introduced port-access technique. Methods. Experimental design: Prospective collection of data from the month of October 1997. Setting: Regional University Hospital. Patients: Adult patients undergoing coronary bypass graft or mitral valve surgery. Interventions: Port-access technique makes it possible to carry out open-heart procedures through a minithoracotomy and extrathoracic cardiopulmonary bypass with a set of properly designed catheters (Heartport EndoCPB(TM) system) for cardioplegia delivery and heart venting. Measures: Transesophageal echography and pressure traces are the main monitoring tools used for the correct placement of these catheters and for the clinical management of the patient. Results. Sixty-two cases have been performed so far. A complete description of the procedure, with monitoring aspects and problems encountered is thoroughly presented. Conclusions. The major differences with traditional cardiac surgery are that interruption of myocardial perfusion is not achieved through a transversal clamp but through an endovascular occlusive balloon and that thoracic access is by minithoracotomy. Unlike traditional open surgery, the surgeon has no direct vision of the position of the clamp and the anesthesiologist can not visually inspect the contractile state of the heart. The operative team has to cope with a multifaceted system of monitored variables that must be continuously integrated and interpreted. Tight cooperation and continuous communication between anaesthesiologist, surgeons and perfusionist appear to be more important than in any other cardiac operation.

Original languageEnglish
Pages (from-to)579-583
Number of pages5
JournalJournal of Cardiovascular Surgery
Volume41
Issue number4
Publication statusPublished - 2000

Fingerprint

Thoracic Surgery
Catheters
Induced Heart Arrest
Cardiopulmonary Bypass
Mitral Valve
Ultrasonography
Research Design
Thorax
Perfusion
Communication
Transplants
Pressure
Surgeons
Anesthesiologists

Keywords

  • Cardiac surgical procedures methods
  • Coronary artery bypass methods
  • Mitral valve surgery
  • Surgical procedures, minimally invasive

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Ceriana, P., Pagnin, A., Locatelli, A., Maurelli, M., Minzioni, G., Spreafico, P., ... Vigano, M. (2000). Monitoring aspects during port-access cardiac surgery. Journal of Cardiovascular Surgery, 41(4), 579-583.

Monitoring aspects during port-access cardiac surgery. / Ceriana, P.; Pagnin, A.; Locatelli, A.; Maurelli, M.; Minzioni, G.; Spreafico, P.; Degani, A.; Vigano, M.

In: Journal of Cardiovascular Surgery, Vol. 41, No. 4, 2000, p. 579-583.

Research output: Contribution to journalArticle

Ceriana, P, Pagnin, A, Locatelli, A, Maurelli, M, Minzioni, G, Spreafico, P, Degani, A & Vigano, M 2000, 'Monitoring aspects during port-access cardiac surgery', Journal of Cardiovascular Surgery, vol. 41, no. 4, pp. 579-583.
Ceriana P, Pagnin A, Locatelli A, Maurelli M, Minzioni G, Spreafico P et al. Monitoring aspects during port-access cardiac surgery. Journal of Cardiovascular Surgery. 2000;41(4):579-583.
Ceriana, P. ; Pagnin, A. ; Locatelli, A. ; Maurelli, M. ; Minzioni, G. ; Spreafico, P. ; Degani, A. ; Vigano, M. / Monitoring aspects during port-access cardiac surgery. In: Journal of Cardiovascular Surgery. 2000 ; Vol. 41, No. 4. pp. 579-583.
@article{7d7c03ed570b45b9a93de1303a432aef,
title = "Monitoring aspects during port-access cardiac surgery",
abstract = "Objective. To report the experience gained at our Cardiosurgical Centre with the recently introduced port-access technique. Methods. Experimental design: Prospective collection of data from the month of October 1997. Setting: Regional University Hospital. Patients: Adult patients undergoing coronary bypass graft or mitral valve surgery. Interventions: Port-access technique makes it possible to carry out open-heart procedures through a minithoracotomy and extrathoracic cardiopulmonary bypass with a set of properly designed catheters (Heartport EndoCPB(TM) system) for cardioplegia delivery and heart venting. Measures: Transesophageal echography and pressure traces are the main monitoring tools used for the correct placement of these catheters and for the clinical management of the patient. Results. Sixty-two cases have been performed so far. A complete description of the procedure, with monitoring aspects and problems encountered is thoroughly presented. Conclusions. The major differences with traditional cardiac surgery are that interruption of myocardial perfusion is not achieved through a transversal clamp but through an endovascular occlusive balloon and that thoracic access is by minithoracotomy. Unlike traditional open surgery, the surgeon has no direct vision of the position of the clamp and the anesthesiologist can not visually inspect the contractile state of the heart. The operative team has to cope with a multifaceted system of monitored variables that must be continuously integrated and interpreted. Tight cooperation and continuous communication between anaesthesiologist, surgeons and perfusionist appear to be more important than in any other cardiac operation.",
keywords = "Cardiac surgical procedures methods, Coronary artery bypass methods, Mitral valve surgery, Surgical procedures, minimally invasive",
author = "P. Ceriana and A. Pagnin and A. Locatelli and M. Maurelli and G. Minzioni and P. Spreafico and A. Degani and M. Vigano",
year = "2000",
language = "English",
volume = "41",
pages = "579--583",
journal = "Journal of Cardiovascular Surgery",
issn = "0021-9509",
publisher = "Edizioni Minerva Medica S.p.A.",
number = "4",

}

TY - JOUR

T1 - Monitoring aspects during port-access cardiac surgery

AU - Ceriana, P.

AU - Pagnin, A.

AU - Locatelli, A.

AU - Maurelli, M.

AU - Minzioni, G.

AU - Spreafico, P.

AU - Degani, A.

AU - Vigano, M.

PY - 2000

Y1 - 2000

N2 - Objective. To report the experience gained at our Cardiosurgical Centre with the recently introduced port-access technique. Methods. Experimental design: Prospective collection of data from the month of October 1997. Setting: Regional University Hospital. Patients: Adult patients undergoing coronary bypass graft or mitral valve surgery. Interventions: Port-access technique makes it possible to carry out open-heart procedures through a minithoracotomy and extrathoracic cardiopulmonary bypass with a set of properly designed catheters (Heartport EndoCPB(TM) system) for cardioplegia delivery and heart venting. Measures: Transesophageal echography and pressure traces are the main monitoring tools used for the correct placement of these catheters and for the clinical management of the patient. Results. Sixty-two cases have been performed so far. A complete description of the procedure, with monitoring aspects and problems encountered is thoroughly presented. Conclusions. The major differences with traditional cardiac surgery are that interruption of myocardial perfusion is not achieved through a transversal clamp but through an endovascular occlusive balloon and that thoracic access is by minithoracotomy. Unlike traditional open surgery, the surgeon has no direct vision of the position of the clamp and the anesthesiologist can not visually inspect the contractile state of the heart. The operative team has to cope with a multifaceted system of monitored variables that must be continuously integrated and interpreted. Tight cooperation and continuous communication between anaesthesiologist, surgeons and perfusionist appear to be more important than in any other cardiac operation.

AB - Objective. To report the experience gained at our Cardiosurgical Centre with the recently introduced port-access technique. Methods. Experimental design: Prospective collection of data from the month of October 1997. Setting: Regional University Hospital. Patients: Adult patients undergoing coronary bypass graft or mitral valve surgery. Interventions: Port-access technique makes it possible to carry out open-heart procedures through a minithoracotomy and extrathoracic cardiopulmonary bypass with a set of properly designed catheters (Heartport EndoCPB(TM) system) for cardioplegia delivery and heart venting. Measures: Transesophageal echography and pressure traces are the main monitoring tools used for the correct placement of these catheters and for the clinical management of the patient. Results. Sixty-two cases have been performed so far. A complete description of the procedure, with monitoring aspects and problems encountered is thoroughly presented. Conclusions. The major differences with traditional cardiac surgery are that interruption of myocardial perfusion is not achieved through a transversal clamp but through an endovascular occlusive balloon and that thoracic access is by minithoracotomy. Unlike traditional open surgery, the surgeon has no direct vision of the position of the clamp and the anesthesiologist can not visually inspect the contractile state of the heart. The operative team has to cope with a multifaceted system of monitored variables that must be continuously integrated and interpreted. Tight cooperation and continuous communication between anaesthesiologist, surgeons and perfusionist appear to be more important than in any other cardiac operation.

KW - Cardiac surgical procedures methods

KW - Coronary artery bypass methods

KW - Mitral valve surgery

KW - Surgical procedures, minimally invasive

UR - http://www.scopus.com/inward/record.url?scp=0033810725&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033810725&partnerID=8YFLogxK

M3 - Article

C2 - 11052287

AN - SCOPUS:0033810725

VL - 41

SP - 579

EP - 583

JO - Journal of Cardiovascular Surgery

JF - Journal of Cardiovascular Surgery

SN - 0021-9509

IS - 4

ER -