Monitoring Considerations for Port-Access Cardiac Surgery

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Presentation transcript:

Monitoring Considerations for Port-Access Cardiac Surgery by Lawrence C. Siegel, Frederick G. St. Goar, John H. Stevens, Mario F. Pompili, Thomas A. Burdon, Bruce A. Reitz, and William S. Peters Circulation Volume 96(2):562-568 July 15, 1997 Copyright © American Heart Association, Inc. All rights reserved.

Endovascular cardiopulmonary bypass system catheters. Lawrence C. Siegel et al. Circulation. 1997;96:562-568 Copyright © American Heart Association, Inc. All rights reserved.

Endovascular cardiopulmonary bypass circuit. Endovascular cardiopulmonary bypass circuit. KAVD indicates kinetic-assisted venous drainage. Lawrence C. Siegel et al. Circulation. 1997;96:562-568 Copyright © American Heart Association, Inc. All rights reserved.

Fluoroscopic image of pulmonary vent catheter insertion. Lawrence C. Siegel et al. Circulation. 1997;96:562-568 Copyright © American Heart Association, Inc. All rights reserved.

A, Fluoroscopic image of the coronary sinus catheter located in the coronary sinus with the balloon inflated and contrast injected into the coronary sinus. A, Fluoroscopic image of the coronary sinus catheter located in the coronary sinus with the balloon inflated and contrast injected into the coronary sinus. B, Transesophageal echocardiography (TEE) image of the coronary sinus catheter located in the coronary sinus. Lawrence C. Siegel et al. Circulation. 1997;96:562-568 Copyright © American Heart Association, Inc. All rights reserved.

Transesophageal echocardiography (TEE) image of the femoral venous cannula with the tip located in the superior vena cava. Transesophageal echocardiography (TEE) image of the femoral venous cannula with the tip located in the superior vena cava. RA indicates right atrium; FVC, femoral venous cannula; and SVC, superior vena cava. Lawrence C. Siegel et al. Circulation. 1997;96:562-568 Copyright © American Heart Association, Inc. All rights reserved.

Transesophageal echocardiography (TEE) image of the endoaortic clamp in the ascending aorta before balloon inflation. Transesophageal echocardiography (TEE) image of the endoaortic clamp in the ascending aorta before balloon inflation. This initial positioning can be accomplished before initiation of cardiopulmonary bypass. Lawrence C. Siegel et al. Circulation. 1997;96:562-568 Copyright © American Heart Association, Inc. All rights reserved.

A, Fluoroscopic image of the endoaortic clamp catheter in the ascending aorta. A, Fluoroscopic image of the endoaortic clamp catheter in the ascending aorta. After initiation of cardiopulmonary bypass, the balloon was inflated with diluted radiographic contrast solution, and injection of this solution defines the position of the balloon in the ascending aorta. B, Transesophageal echocardiography (TEE) image of the endoaortic clamp balloon in the ascending aorta. Lawrence C. Siegel et al. Circulation. 1997;96:562-568 Copyright © American Heart Association, Inc. All rights reserved.

Right carotid artery flow during cardiopulmonary bypass is confirmed with pulsed-wave Doppler, indicating that the endoaortic clamp is positioned in the ascending aorta and is not disrupting cardiopulmonary bypass flow to the aortic arch. Right carotid artery flow during cardiopulmonary bypass is confirmed with pulsed-wave Doppler, indicating that the endoaortic clamp is positioned in the ascending aorta and is not disrupting cardiopulmonary bypass flow to the aortic arch. Lawrence C. Siegel et al. Circulation. 1997;96:562-568 Copyright © American Heart Association, Inc. All rights reserved.