Alternative peripheral perfusion strategies for safe cardiopulmonary bypass in XXXX closure via a right minithoracotomy approach.

@entity1 @entity64 @entity583 @entity118 @entity204
OBJECTIVES: In cases of cardiac surgery via a minimally invasive right minithoracotomy approach, cardiopulmonary bypass is established with peripheral arterial cannulation, frequently with a single femoral artery. Occasionally, alternative perfusion access is required to prevent perfusion site-related complications. In this study, the feasibility of alternative perfusion strategies was verified by comparing the postoperative outcomes and complications. METHODS: The records of 91 consecutive @entity1 (68 @entity1 , 23 @entity1 ; mean age 40.7      16.5  years) who underwent @entity118 ( @entity118 ) closure via a right minithoracotomy approach between January 2009 and September 2014 were reviewed. @entity1 were divided into two groups: those with single femoral arterial access (SF group, n  =  84), and those with alternative perfusion access (ALT group, n  =  7, bilateral femoral arterial cannulation in 6, side-arm graft anastomosed to the femoral artery in 1). RESULTS: Femoral artery diameter was smaller in the ALT group than in the SF group (6.5      0.5 vs. 7.3      1.0  mm, P  =  0.013). Operating time was longer in the ALT group than in the SF group (259.2      54.0 vs. 208.3      54.9  min, P  =  0.031). One @entity1 was converted to ascending aortic cannulation owing to high perfusion pressure. Postoperative major cardiac or cerebrovascular events, such as @entity204 , @entity64 , or @entity583 , did not occur in either group. CONCLUSIONS: Alternative perfusion access was safe in @entity118 closure via a right minithoracotomy approach. Precise preoperative evaluation of the iliofemoral artery is important for choosing the appropriate perfusion strategy.
