Hyperkalemic arrest and the aortic no-touch technique in minimally invasive atrial septal defect closure in adults

To avoid aortic cross-clamping and cardioplegic ischaemia, we propose the induction of hyperkalemic arrest and using aortic no-touch technique in minimally invasive atrial septal defect (ASD) closure. Twenty-eight patients were included in this study. After establishment of cardiopulmonary bypass, potassium was administered to induce hyperkalemic arrest. The mean dose of injected potassium was 1.2 ± 0.45 mEq/kg. Following the direct closure of the ASD, potassium was filtered out using a hemodialyzer. At the end of the operation, serum potassium was normalized to 4.1 ± 0.5 mEq/l. The mean arrest time was 11 ± 4.4 min without complications. Hyperkalemic arrest in combination with aortic no-touch technique is safe and efficacious in minimally invasive ASD closure.