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Updated: Sep 17, 2025
08:12
Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
1.8K
Percutaneous Cannulation for Minimally Invasive Heart Valve Surgery: Results from a Multicenter Registry.
Jonas Pausch1, Jessica Weimann2, Miriam Silaschi3
1Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
Summary
Plug-based vascular closure devices (VCDs) demonstrate superior immediate hemostasis and reduced need for additional interventions compared to suture-based VCDs in minimally invasive heart valve surgery. Both methods show low complication rates for percutaneous femoral cannulation.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Procedures
- Vascular Access Management
Background:
- Percutaneous femoral cannulation is increasingly used for cardiopulmonary bypass in minimally invasive heart valve surgery (HVS).
- Vascular closure devices (VCDs) aim to reduce complications associated with groin incisions.
- Comparing plug-based versus suture-based VCDs for percutaneous access site closure in HVS is crucial for optimizing surgical outcomes.
Purpose of the Study:
- To evaluate the safety and efficacy of plug-based versus suture-based VCDs for vascular access site (VAS) closure.
- To compare major and minor VAS-related complications following percutaneous femoral cannulation in minimally invasive HVS.
Main Methods:
- A multicentre registry (PROMISE) retrospectively analyzed 755 patients undergoing minimally invasive HVS with percutaneous femoral cannulation.
- Patients received either plug-based (group 1) or suture-based (group 2) VCDs for VAS closure.
- Complications were assessed using modified Valve Academic Research Consortium (VARC) 3 criteria.
Main Results:
- Immediate hemostasis was significantly higher with plug-based VCDs (99.8%) compared to suture-based VCDs (77.7%).
- Plug-based VCDs showed significantly lower rates of requiring a second VCD (0.0% vs 34.8%) and conversion to surgical cut-down (1.3% vs 3.9%).
- Overall VAS-related complication rates were low in both groups (2.9% vs 5.2%), with no significant difference in specific complications like AV fistula or pseudoaneurysm.
Conclusions:
- Both plug-based and suture-based VCDs are feasible and safe for VAS closure after percutaneous cannulation in minimally invasive HVS.
- Plug-based VCDs offer advantages of higher immediate hemostasis rates and reduced need for additional closure interventions or surgical conversion.
- Dedicated VCD usage effectively minimizes invasiveness in minimally invasive HVS procedures.
Keywords:
endoscopic heart valve surgerygroin complicationsminimally invasive heart valve surgeryplug-based VCDsuture-based VCDvascular access site closurevascular closure deviceMore Related Videos
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