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Cava endoluminal balloon occlusion as an adjunct technique to perform less invasive cardiopulmonary bypass procedures
J Q Melo1, J P Neves, M Abecassis
1Department of Cardiothoracic Surgery, Hospital de Santa Cruz, Carnaxide, Portugal.
Insights
A novel Cavae Endoluminal Balloon Occlusion (CEBO) technique offers a less invasive approach for right-sided heart surgeries and reoperations. This method demonstrated safety and improved postoperative recovery in patients undergoing complex cardiac procedures.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Procedures
- Cardiac Anesthesiology
Background:
- Traditional cardiopulmonary bypass can involve extensive dissection, particularly in reoperations.
- Accessing right-sided cardiac lesions often requires specific surgical approaches.
- Minimally invasive techniques are increasingly sought after in cardiac surgery.
Purpose of the Study:
- To develop and evaluate a less invasive cardiopulmonary bypass technique for right-sided heart lesions.
- To assess the feasibility of avoiding extensive dissection in cardiac reoperations using a novel approach.
- To introduce the Cavae Endoluminal Balloon Occlusion (CEBO) technique.
Main Methods:
- Cavae Endoluminal Balloon Occlusion (CEBO) was achieved using balloon catheters inserted via jugular and femoral veins.
- The CEBO technique was employed with standard femoral cardiopulmonary bypass or port-access techniques.
- Twenty-two patients underwent surgery via right thoracotomy for atrial septal defects or tricuspid valve pathology.
Main Results:
- No mortality was observed in the 22 patients operated on.
- Two intra-operative complications occurred, partly attributed to technique development and material limitations.
- Patients experienced shorter and easier postoperative care, indicating improved recovery.
Conclusions:
- The CEBO technique is a safe and effective adjunct for minimally invasive cardiac surgery.
- This method facilitates complex reoperations on the right side of the heart.
- CEBO shows promise in reducing surgical invasiveness and improving patient outcomes.
Objectives:
A cardiopulmonary bypass technique was developed with the aim of achieving a less invasive approach to right-sided lesions of the heart or to avoid extensive dissection in reoperations.
Methods:
Cavae endoluminal balloon occlusion (CEBO) was achieved with balloon catheters, introduced through cannulas inserted in the right jugular and one of the femoral veins. This procedure can be used in association with a standard femoral cardiopulmonary bypass or with the port-access technique.
Results:
Twenty-two patients were operated, through a right thoracotomy, for atrial septal defect (19) and tricuspid valve regurgitation associated with mitral valve pathology (3). There were two intra-operative complications, partially related with the development of this technique and lack of appropriate designed material. There was no mortality and a shorter and easier postoperative care was achieved in almost all patients.
Conclusions:
The CEBO technique is an useful and safe adjunct to perform miniinvasive or complex reoperations on the right side of the heart.