Port-access cardiac operations with cardioplegic arrest

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Techniques
• Medical Device Technology

Background:

• Advances in video-assisted surgery are driving less invasive cardiac procedures.
• Previous minimally invasive cardiac surgery faced challenges in exposure, perfusion, and myocardial protection.
• These limitations hindered the widespread adoption of minimally invasive cardiac operations.

Purpose of the Study:

• To evaluate the efficacy of port-access technology in minimally invasive cardiac surgery.
• To demonstrate the capability of endovascular aortic occlusion and cardioplegia delivery.
• To assess the potential for improved myocardial protection during cardiac procedures.

Main Methods:

• The port-access system utilizes an endoaortic clamp for endovascular aortic occlusion.
• This clamp facilitates cardioplegia delivery and left ventricular decompression.
• The system includes lumens for antegrade cardioplegia, aortic root venting, pressure monitoring, and balloon occlusion.

Main Results:

• Port-access technology has shown feasibility in coronary artery bypass grafting and mitral valve procedures.
• Endovascular cardiopulmonary bypass with the endoaortic clamp effectively achieved cardiac arrest and myocardial protection.
• A still, bloodless field was achieved, enabling precise anastomosis for coronary artery bypass grafting.
• Intracardiac procedures, including mitral valve replacement and repair, have been successfully performed clinically.

Conclusions:

• The port-access system enables effective cardiopulmonary bypass and cardioplegic arrest for minimally invasive cardiac surgery.
• It provides surgeons with endovascular aortic occlusion, cardioplegia delivery, and left ventricular decompression capabilities.
• This technology facilitates the performance of complex cardiac procedures in a minimally invasive manner.