Central Aortic Cannulation in Minimally Invasive Cardiac Surgery via Right Thoracotomy: A Single-Center Retrospective...

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Cardiac Surgery
• Thoracic Surgery

Background:

• Minimally invasive cardiac surgery via right thoracotomy often uses femoral arterial cannulation for cardiopulmonary bypass (CPB).
• Femoral cannulation requires an additional groin incision and carries risks of access-related complications.
• Central aortic cannulation through the thoracotomy offers antegrade perfusion without an extra incision.

Purpose of the Study:

• To compare central aortic cannulation versus femoral arterial cannulation strategies in minimally invasive right thoracotomy cardiac surgery.
• To evaluate operative variables, transfusion needs, biochemical parameters, and early postoperative outcomes.

Main Methods:

• Retrospective, single-center study of 139 patients undergoing minimally invasive right thoracotomy cardiac surgery with CPB (February 2021 - June 2023).
• Patients were divided into central aortic cannulation (n=93) and femoral arterial cannulation (n=46) groups.
• Comparison of demographic data, operative variables, and early clinical outcomes.

Main Results:

• Baseline demographics differed significantly between groups (e.g., age, height, sex).
• Femoral cannulation group had longer cross-clamp and CPB durations.
• Lymphatic leakage occurred in 6.5% of the femoral group versus 0% in the central group (p=0.009).
• No significant differences in mortality, ICU stay, or neurological events were observed.

Conclusions:

• Central aortic cannulation is a feasible alternative to femoral cannulation for minimally invasive right thoracotomy cardiac surgery.
• This approach avoids groin incisions, reduces operative time, and may decrease access-related complications like lymphatic leakage.
• Comparable early clinical outcomes were achieved, though findings require cautious interpretation due to study design and baseline differences.