BACKGROUND We report two cases of acute femoral artery occlusion following the use of ProGlide in minimally invasive cardiac surgery and insertion of large-bore catheters through the common femoral artery.This will ad...BACKGROUND We report two cases of acute femoral artery occlusion following the use of ProGlide in minimally invasive cardiac surgery and insertion of large-bore catheters through the common femoral artery.This will add to the existing body of literature by highlighting the possible complications associated with the use of ProGlide and reiterate that the use of the sono-guided ProGlide skill will reduce the incidence of these complications.CASE SUMMARY A 78-year-old man underwent minimally invasive cardiac surgery for severe aortic valve stenosis.After the operation,the puncture site of the common femoral artery was closed using ProGlide.The next morning,after regaining consciousness,he complained of pain,motor weakness(grade 2),and coldness in the right lower extremity.A 65-year-old man underwent minimally invasive cardiac surgery for a large secundum atrial septal defect(5 cm×5 cm).After the operation,the puncture site of the common femoral artery was closed using ProGlide.After extubation,the patient complained of paresthesia of the right thigh.Both the patients underwent emergency surgery for acute occlusion of the common femoral artery.CONCLUSION If the sono-guided ProGlide skill is used,complications can be prevented,and ProGlide can be safely used.展开更多
Background: Minimally invasive procedures lead to less scarring resulting in better cosmetic outcomes. This has resulted in increased patient interest in such procedures and this has motivated surgeons to pursue newer...Background: Minimally invasive procedures lead to less scarring resulting in better cosmetic outcomes. This has resulted in increased patient interest in such procedures and this has motivated surgeons to pursue newer and improved techniques for Minimally invasive cardiac surgery (MICS). Obviously, with the advent of MICS the techniques to achieve it also needed to be changed and upgraded which includes access for cannulation for cardiopulmonary bypass (CPB). Right internal jugular vein percutaneous cannulation, together with the direct surgical cannulation of femoral vessels with minithoracotomy/ministernotomy proves to be a safe and effective tool in patients with body weight of above 20 kg for minimally access cardiac surgery. We use this technique for Atrial septal defect (ASD) closure, aortic valve replacement (AVR), redo Tricuspid valve replacement (TVR) and mitral valve replacement (MVR). Here, we describe our experience with minimally invasive approach using total peripheral cannulation and an anterior mini-thoracotomy (6 cm or less) incision for ASD closure, AVR, TVR and MVR. Methods: The preoperative variables, intraoperative data and postoperative outcomes of patients undergoing minimally invasive ASD closure, AVR, TVR and MVR with total peripheral cannulation were collected and analyzed. Results: Between May 2014 to May 2019 we performed minimally invasive closure of atrial septal defects, AVR, TVR and MVR with total peripheral cannulation in 103 patients. There were 64 females and 39 males Mean age was 25 years (range 8 - 58 years), Spectrum of procedures include ASD closure in 81 patients (78.6%), AVR via minithoracotomy in 13 patients (12.6%) and AVR via ministernotomy in 3 patients (2.9%), redo TVR in 5 (4.8%), MVR in 1 patient (0.97%). Average cardiopulmonary bypass (CPB) time was 46 minutes (range 22 - 78 min) and average aortic cross-clamp time (AoX) 26 min (range 12 - 45 min) in ASD closure group. In AVR group average CPB time was 91 min (range 72 - 120 min) and AoX time 76.5 min (range 65 - 109 min). In TVR group average CPB time 54 min (range 45 - 67 min) on beating heart. Only one MVR done in this period and CPB time was 82 min and AoX time was 65 min. The mean length of stay in intensive care unit was 1.8 days in ASD closure, 2 days in AVR group when in TVR group 3.5 days, and hospital stay was 3 days in ASD closure group, 4 days in AVR group and 7 days in TVR group. The only one patient who underwent MVR died in 12<sup>th</sup> post operative day from sepsis. There was one late mortality in AVR group after reoperation for prosthetic valve endocarditis at 3 months from first operation. Conclusion: ASD closure, AVR, TVR and MVR with mini invasive approach is safe with very few manageable preoperative complications and good patient satisfaction.展开更多
Background To explore the effect of single-lumen tube with high-frequency low-tide ventilation mode to optimize nursing measures on patients’rapid recovery.Methods From October 2021 to December 2022,the clinical data...Background To explore the effect of single-lumen tube with high-frequency low-tide ventilation mode to optimize nursing measures on patients’rapid recovery.Methods From October 2021 to December 2022,the clinical data of 115 patients who underwent thoracoscopic mitral or/and tricuspid valve surgery in the Department of Cardiology,Guangdong Provincial People’s Hospital were selected.Patients underwent minimally invasive cardiac surgery with single-lumen tube(SLT)or double-lumen tube(DLT),and both groups adopted nursing measures of relieving anxiety and fear before operation,cooperating with doctors accurately and tacitly during operation,and paying attention to airway management after operation.The surgical variables and postoperative complications were recorded and analyzed.Results Among the 115 patients,57 cases were intubated with single-lumen and 58 cases were intubated with double-lumen.In the single-lumen tube group,the 24-hour thoracic fluid volume,postoperative hospitalization time,sputum aspiration times and intensive care unit(ICU)hospitalization time were significantly reduced(P<0.05).But there was no difference in postoperative complications and mechanical ventilation time between the two groups.Conclusion In minimally invasive cardiac surgery,optimizing perioperative nursing measures and inserting single-lumen tracheal intubation can accelerate the postoperative rehabilitation of patients compared with double-lumen tracheal intubation.展开更多
We report the case of three female patients who were scheduled for surgical correction of residual left-to-right shunt after initial repair of sinus venosus atrial septal defect(SV-ASD)during childhood.After excluding...We report the case of three female patients who were scheduled for surgical correction of residual left-to-right shunt after initial repair of sinus venosus atrial septal defect(SV-ASD)during childhood.After excluding the possibility of an hemodynamic intervention,all three patients underwent a successful surgical closure through a right mini sub-axillary approach by using total peripheral cannulation for cardiopulmonary bypass and leaving the inferior vena cava completely un-snared allowing for an optimal visualization of the residual atrial septal communication and avoiding extensive dissection of mediastinal structures.展开更多
文摘BACKGROUND We report two cases of acute femoral artery occlusion following the use of ProGlide in minimally invasive cardiac surgery and insertion of large-bore catheters through the common femoral artery.This will add to the existing body of literature by highlighting the possible complications associated with the use of ProGlide and reiterate that the use of the sono-guided ProGlide skill will reduce the incidence of these complications.CASE SUMMARY A 78-year-old man underwent minimally invasive cardiac surgery for severe aortic valve stenosis.After the operation,the puncture site of the common femoral artery was closed using ProGlide.The next morning,after regaining consciousness,he complained of pain,motor weakness(grade 2),and coldness in the right lower extremity.A 65-year-old man underwent minimally invasive cardiac surgery for a large secundum atrial septal defect(5 cm×5 cm).After the operation,the puncture site of the common femoral artery was closed using ProGlide.After extubation,the patient complained of paresthesia of the right thigh.Both the patients underwent emergency surgery for acute occlusion of the common femoral artery.CONCLUSION If the sono-guided ProGlide skill is used,complications can be prevented,and ProGlide can be safely used.
文摘Background: Minimally invasive procedures lead to less scarring resulting in better cosmetic outcomes. This has resulted in increased patient interest in such procedures and this has motivated surgeons to pursue newer and improved techniques for Minimally invasive cardiac surgery (MICS). Obviously, with the advent of MICS the techniques to achieve it also needed to be changed and upgraded which includes access for cannulation for cardiopulmonary bypass (CPB). Right internal jugular vein percutaneous cannulation, together with the direct surgical cannulation of femoral vessels with minithoracotomy/ministernotomy proves to be a safe and effective tool in patients with body weight of above 20 kg for minimally access cardiac surgery. We use this technique for Atrial septal defect (ASD) closure, aortic valve replacement (AVR), redo Tricuspid valve replacement (TVR) and mitral valve replacement (MVR). Here, we describe our experience with minimally invasive approach using total peripheral cannulation and an anterior mini-thoracotomy (6 cm or less) incision for ASD closure, AVR, TVR and MVR. Methods: The preoperative variables, intraoperative data and postoperative outcomes of patients undergoing minimally invasive ASD closure, AVR, TVR and MVR with total peripheral cannulation were collected and analyzed. Results: Between May 2014 to May 2019 we performed minimally invasive closure of atrial septal defects, AVR, TVR and MVR with total peripheral cannulation in 103 patients. There were 64 females and 39 males Mean age was 25 years (range 8 - 58 years), Spectrum of procedures include ASD closure in 81 patients (78.6%), AVR via minithoracotomy in 13 patients (12.6%) and AVR via ministernotomy in 3 patients (2.9%), redo TVR in 5 (4.8%), MVR in 1 patient (0.97%). Average cardiopulmonary bypass (CPB) time was 46 minutes (range 22 - 78 min) and average aortic cross-clamp time (AoX) 26 min (range 12 - 45 min) in ASD closure group. In AVR group average CPB time was 91 min (range 72 - 120 min) and AoX time 76.5 min (range 65 - 109 min). In TVR group average CPB time 54 min (range 45 - 67 min) on beating heart. Only one MVR done in this period and CPB time was 82 min and AoX time was 65 min. The mean length of stay in intensive care unit was 1.8 days in ASD closure, 2 days in AVR group when in TVR group 3.5 days, and hospital stay was 3 days in ASD closure group, 4 days in AVR group and 7 days in TVR group. The only one patient who underwent MVR died in 12<sup>th</sup> post operative day from sepsis. There was one late mortality in AVR group after reoperation for prosthetic valve endocarditis at 3 months from first operation. Conclusion: ASD closure, AVR, TVR and MVR with mini invasive approach is safe with very few manageable preoperative complications and good patient satisfaction.
文摘Background To explore the effect of single-lumen tube with high-frequency low-tide ventilation mode to optimize nursing measures on patients’rapid recovery.Methods From October 2021 to December 2022,the clinical data of 115 patients who underwent thoracoscopic mitral or/and tricuspid valve surgery in the Department of Cardiology,Guangdong Provincial People’s Hospital were selected.Patients underwent minimally invasive cardiac surgery with single-lumen tube(SLT)or double-lumen tube(DLT),and both groups adopted nursing measures of relieving anxiety and fear before operation,cooperating with doctors accurately and tacitly during operation,and paying attention to airway management after operation.The surgical variables and postoperative complications were recorded and analyzed.Results Among the 115 patients,57 cases were intubated with single-lumen and 58 cases were intubated with double-lumen.In the single-lumen tube group,the 24-hour thoracic fluid volume,postoperative hospitalization time,sputum aspiration times and intensive care unit(ICU)hospitalization time were significantly reduced(P<0.05).But there was no difference in postoperative complications and mechanical ventilation time between the two groups.Conclusion In minimally invasive cardiac surgery,optimizing perioperative nursing measures and inserting single-lumen tracheal intubation can accelerate the postoperative rehabilitation of patients compared with double-lumen tracheal intubation.
文摘We report the case of three female patients who were scheduled for surgical correction of residual left-to-right shunt after initial repair of sinus venosus atrial septal defect(SV-ASD)during childhood.After excluding the possibility of an hemodynamic intervention,all three patients underwent a successful surgical closure through a right mini sub-axillary approach by using total peripheral cannulation for cardiopulmonary bypass and leaving the inferior vena cava completely un-snared allowing for an optimal visualization of the residual atrial septal communication and avoiding extensive dissection of mediastinal structures.
