Cardioplegia Delivery by Transcutaneous Pigtail Catheter in Minimally Invasive Mitral Valve Operations Kuan-Ming Chiu, MD, PhD, Robert Jeen-chen Chen,

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Cardioplegia Delivery by Transcutaneous Pigtail Catheter in Minimally Invasive Mitral Valve Operations Kuan-Ming Chiu, MD, PhD, Robert Jeen-chen Chen, MD, MPH, Tzu-Yu Lin, MD, PhD, Jer-Shen Chen, MD, Jih-Hsin Huang, MD, Shu- Hsun Chu, MD The Annals of Thoracic Surgery Volume 95, Issue 3, Pages e77-e78 (March 2013) DOI: 10.1016/j.athoracsur.2012.10.065 Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Specifications of pigtail catheter. Assembled together from inside out, needle punctures, stylus guides, and catheter advances into target. The Annals of Thoracic Surgery 2013 95, e77-e78DOI: (10.1016/j.athoracsur.2012.10.065) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Illustration of pigtail cardioplegia and removal of air (photos taken from several patients). (A) Pigtail penetrates chest wall and points toward aorta. (B) When pump is on, pigtail punctures aorta, without purse-string suture. (C) After Chitwood cross-clamping, pigtail delivers cardioplegia. (D) Pigtail removes air and a pledgeted purse-string suture is used for removal. The Annals of Thoracic Surgery 2013 95, e77-e78DOI: (10.1016/j.athoracsur.2012.10.065) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions