Alternative method for cardioplegia delivery during totally endoscopic robotic intracardiac surgery

The optimal technique for antegrade cardioplegia delivery during totally endoscopic robotic surgery is still evolving. Cardioplegia delivery with endovascular balloon clamping of the aorta is commonly used but this method has several disadvantages and may lead to serious complications. We describe a novel cardioplegia delivery procedure for totally endoscopic intracardiac surgeries such as atrial septal defect closure and mitral valve repair. The method uses a transthoracic aortic clamp and an antegrade cardioplegia cannula without the need for thoracotomy. The technique is safe and reliable, permits simple cardioplegic arrest, and prevents complications related to endovascular balloon clamping during robot-assisted intracardiac surgery.