| Monitoring considerations for port-access cardiac surgery. | |
| | |
MedLine Citation:
|
PMID: 9244226 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: A method for monitoring patients was evaluated in a clinical trial of minimally invasive port-access cardiac surgery with closed chest endovascular cardiopulmonary bypass. METHODS AND RESULTS: Cardiopulmonary bypass was conducted in 25 patients through femoral cannulas. An endovascular pulmonary artery vent was placed in the main pulmonary artery through a jugular vein. For mitral valve surgery, a catheter was placed in the coronary sinus for delivery of cardioplegia. A balloon catheter ("endoaortic clamp," EAC) used for occlusion of the ascending aorta, delivery of cardioplegia, aortic root venting, and pressure measurement was inserted through a femoral artery and initially positioned by use of fluoroscopy and transesophageal echocardiography (TEE). Potential migration of the EAC was monitored by (1) TEE of the ascending aorta, (2) pulsed-wave Doppler of the right carotid artery, (3) balloon pressure, (4) comparison of aortic root pressure and right radial artery pressure, and (5) fluoroscopy. TEE, fluoroscopy, and pressure measurement were effective in monitoring catheter insertion and position. With inadequate balloon inflation, migration of the EAC toward the aortic valve could be detected with TEE. During administration of cardioplegia, TEE showed movement of the balloon away from the aortic valve, and migration into the aortic arch was detectable with loss of carotid Doppler flow. Stability of EAC position was demonstrated with appropriate balloon volume. Cardioplegic solution was visualized in the aortic root, and aortic root pressure changed appropriately during administration of cardioplegia. Venous cannula position was optimized with TEE and endopulmonary vent flow measurement. CONCLUSIONS: An effective method has been developed for monitoring patients and the catheter system during port-access cardiac surgery. |
| | |
Authors:
|
L C Siegel; F G St Goar; J H Stevens; M F Pompili; T A Burdon; B A Reitz; W S Peters |
Related Documents
:
|
7817906 - Mechanism of balloon angioplasty in children with arterial stenosis assessed by intrava... 851206 - A new method for internal calibration of left ventricular cineangiography. 2054246 - Balloon dilatation of restrictive interatrial communications in congenital heart disease. 17163346 - Minimally invasive keyhole approach for removal of a migratory balloon complicated by e... 18398396 - Reliability and limitations of angiography in the diagnosis of coronary plaque rupture:... 9164066 - Traumatic aneurysm of the temporal artery: a report of five cases. |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Circulation Volume: 96 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1997 Jul |
Date Detail:
|
Created Date: 1997-08-26 Completed Date: 1997-08-26 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 562-8 Citation Subset: AIM; IM |
Affiliation:
|
Department of Anesthesia, Stanford University School of Medicine, Calif, USA. lsiegel@leland.stanford.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Cardiopulmonary Bypass* Catheterization Humans Monitoring, Intraoperative / instrumentation, methods* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Abnormal epinephrine release in young adults with high personal and high parental blood pressures.
Next Document: Aprotinin inhibits plasmin-induced platelet activation during cardiopulmonary bypass.