Early experience with a new aortic clamping system designed for port access cardiac surgery: the PortaClamp

We report a clinical study to demonstrate the feasibility and safety of a new aortic crossclamping concept for use in port-access cardiac surgery. The limited access to the aorta in minimally invasive cardiac surgery mandates specific clamping modalities, which entail specific limitations, drawbacks, and costs. Therefore a new autoguided, extravascular, and atraumatic clamping system (PortaClamp) was developed to facilitate port-access surgery while potentially avoiding the complications and costs inherent to endoluminal clamping or "blind" crossclamping.

Twenty patients underwent various cardiac operations under cardiopulmonary bypass and aortic crossclamping with the PortaClamp between February and September 2003. The method of aortic clamping is described and the operative course and clinical outcome of the patients are reported as surrogates of feasibility and safety.

The average time to position the clamp was 196 +/- 75 seconds. Crossclamping through a 10-mm port or incision was achieved successfully, enabling cardiac arrest throughout the procedure in every patient. No patient presented with cardiovascular accident or transient ischemic attack, aortic dissection, or hematoma. Intensive care unit times were 12 +/- 3 hours; length of stay was 7.2 +/- 1.1 days.

From this early experience we conclude that the PortaClamp system is safe and can effectively be used to crossclamp the aorta inexpensively to facilitate port-access cardiac surgery. Further comparative studies with the existing systems are warranted to confirm that the atraumatic design provides further benefit.