Format

Send to

Choose Destination
J Cardiothorac Vasc Anesth. 2010 Oct;24(5):746-51. doi: 10.1053/j.jvca.2010.04.001.

The endovascular coronary sinus catheter in minimally invasive mitral and tricuspid valve surgery: a case series.

Author information

1
Department of Anesthesiology, Montreal Heart Institute, Montreal, Quebec, Canada. lebon034@hotmail.com

Abstract

OBJECTIVES:

To determine the safety and efficacy of a standardized approach to the use of an endovascular coronary sinus (CS) catheter during minimally invasive cardiac surgery.

DESIGN:

Case series.

SETTING:

University hospital.

PARTICIPANTS:

Patients undergoing mitral and/or tricuspid valve surgery using a minimally invasive cardiac surgery approach.

INTERVENTIONS:

An endovascular CS catheter was placed to enable the administration of retrograde cardioplegia using transesophageal echocardiography (TEE), fluoroscopy, and CS pressure measurements.

MEASUREMENTS AND MAIN RESULTS:

Data were collected from 96 patient records. A total of 95 (99.0%) endovascular coronary sinus catheters were positioned. The mean time to insert the catheter into the sinus ostium under TEE guidance was 6.3 ± 8.4 minutes. Confirmation of adequate positioning with fluoroscopy took an average of 9.1 ± 10.6 minutes for a mean total procedure time of 16.1 ± 14.1 minutes. Successful positioning, as defined by the ability to generate a perfusion pressure in the CS greater than 30 mmHg during surgery, was achieved in 87.5% of cases. During positioning, ventricularization of the CS pressure curve was observed in 86.0% of cases. The presence of ventricularization was associated with an increase in positioning success (odds ratio = 15.8; 95% confidence interval, 3.713-67.239). One patient developed extravasation of contrast agent after CS catheter placement, without evidence of CS rupture.

CONCLUSIONS:

Endovascular CS catheter insertion can be performed with a high rate of success for positioning and a low complication rate. During positioning, obtaining ventricularization is associated with an increased success rate.

PMID:
20638867
DOI:
10.1053/j.jvca.2010.04.001
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center