Use of carotid artery cannulation during redo sternotomy in congenital cardiac surgery: a single-centre experience
| Autor: | Francesca Iodice, Sergio Filippelli, Gianluca Brancaccio, Gianluigi Perri, Matteo Trezzi, Lorenzo Galletti, Antonio Amodeo, Fiore S. Iorio, Marco Della Porta, Mizar D'Abramo |
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| Rok vydání: | 2021 |
| Předmět: |
Reoperation
Pulmonary and Respiratory Medicine medicine.medical_specialty Heart Injury Carotid Artery Common Carotid arteries 030204 cardiovascular system & hematology Catheterization law.invention Congenital 03 medical and health sciences 0302 clinical medicine law medicine.artery medicine Cardiopulmonary bypass Humans In patient Common carotid artery Cardiac Surgical Procedures Retrospective Studies Cardiopulmonary Bypass business.industry Sternotomy Surgery Cardiac surgery Single centre 030228 respiratory system Composite graft Cardiology and Cardiovascular Medicine business |
| Zdroj: | Interact Cardiovasc Thorac Surg |
| ISSN: | 1569-9285 |
| DOI: | 10.1093/icvts/ivab060 |
| Popis: | OBJECTIVES Management of resternotomy is often a difficult challenge in patients with congenital diseases who have undergone multiple sternotomies. Our goal was to report our single-centre experience with carotid cannulation using a graft interposed during redo sternotomy in complex cardiac reintervention procedures. METHODS We performed a retrospective review of all patients who had undergone complex redo sternotomies between January 2019 and May 2020 utilizing a cervical cannulation technique with a Gore-Tex graft interposed on the carotid artery. We classified our population study on the basis of the primary diagnosis and the type of surgery. The primary outcomes of our analysis were the evaluation of the safety of the procedure in terms of survival and freedom from neurological events. RESULTS We analysed 22 patients who had undergone previous complex operations. The median age and weight at the time of reintervention were 130.35 (range 0.46–435) months and 31.5 (range 2.2–85) kg, respectively. Composite graft carotid cannulation provided adequate arterial flow in all patients with a median arterial flow of 3.5 l/min/m2 (range 0.6–6). One major cardiac injury occurred during sternotomy when emergency cardiopulmonary bypass (CPB) was initiated. Moreover, during their hospital stays, all patients had an uneventful recovery without neurological or vascular complications and no cervical wound infections. CONCLUSIONS Carotid cannulation using interposition of a side graft on the common carotid artery for arterial inflow is a reliable and safe method for initiation of CPB in complex redo surgeries in patients with congenital disease. Complications directly associated with this type of cannulation are uncommon and allow surgical re-entry with overall low risks. |
| Databáze: | OpenAIRE |
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