Percutaneous cannulation for cardiopulmonary bypass in minimally invasive surgery is associated with reduced groin...

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Procedures
• Medical Device Technology

Background:

• Femoral cutdown is the standard approach for groin cannulation in minimally invasive cardiac surgery (MICS).
• Arterial closure devices (ACDs) enable percutaneous placement of larger cannulas, but their benefit in MICS remains unclear.
• Assessing ACDs in MICS is crucial for optimizing surgical access and patient outcomes.

Purpose of the Study:

• To compare the outcomes of percutaneous groin cannulation using ACDs versus conventional surgical cutdown in MICS patients.
• To evaluate the impact of ACDs on operative time, hospital stay, and complication rates.
• To determine the safety and efficacy of ACDs for cardiopulmonary bypass in MICS.

Main Methods:

• A retrospective review of 445 consecutive MICS patients from October 2010 to March 2015.
• Comparison between 92 patients with conventional surgical access (cutdown) and 353 patients using ACDs for groin cannulation.
• Analysis of operative risk, operation time, hospital stay, mobilization time, and complication incidence.

Main Results:

• The ACD group showed significantly reduced operation time (173 min vs. 193 min) and hospital stay (9 days vs. 9 days, P=0.040).
• The incidence of complications was significantly lower in the ACD group (2.3% vs. 8.7%, P=0.007).
• Complications in the ACD group were primarily vascular (dissections, stenoses, injuries), while the cutdown group had more wound infections and lymphatic fistulae.

Conclusions:

• Percutaneous groin cannulation with ACDs significantly decreases groin complications, operation time, and hospital stay in MICS.
• ACDs offer an effective alternative to surgical cutdown for cardiopulmonary bypass in MICS.
• While ACDs reduce certain complications, vigilance for vascular-related issues is necessary.