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Initial experience with percutaneous coronary sinus catheter placement in minimally invasive cardiac surgery in an academic center.

Hanada S, Sakamoto H, Swerczek M, Ueda K - BMC Anesthesiol (2016)

Bottom Line: Patients' characteristics, type of surgery, and transesophageal echocardiography (TEE) findings were compared between the two groups (success group vs. delay/failure group) to identify variables associated with prolongation of the APT or CSC placement failure.The catheter was successfully placed in 74 of those cases.No variables associated with prolongation of APT or CSC placement failure were identified.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesia, University of Iowa Roy J. and Lucille A. Carver College of Medicine, 6JCP, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA.

ABSTRACT

Background: Placement of a percutaneous coronary sinus catheter (CSC) by an anesthesiologist for retrograde cardioplegia in minimally invasive cardiac surgery is relatively safe in experienced hands. However, the popularity of its placement remains limited to a small number of centers due to its perceived complexity and potential complications.

Methods: We retrospectively reviewed all cardiac cases performed by one surgeon between December 2009 and April 2012. The reviewed cases were divided into two groups: cardiac cases with percutaneous CSC placement (CSC group) and cardiac cases without placement (control group). Anesthesia preparation time (APT) was then compared between the CSC group and control group. In the CSC group, cases were further divided into two groups. One group contained cases with an APT of less than 90 min (success group) and the other contained cases with an APT greater than or equal to 90 min or cases with CSC placement failure (delay/failure group). Patients' characteristics, type of surgery, and transesophageal echocardiography (TEE) findings were compared between the two groups (success group vs. delay/failure group) to identify variables associated with prolongation of the APT or CSC placement failure.

Results: Percutaneous CSC placement was required in 83 cases (CSC group). The catheter was successfully placed in 74 of those cases. We experienced one complication, coronary sinus injury after multiple attempts at placing the catheter. The mean APT was 102 ± 31 min in the CSC group (n = 81) and 42 ± 15 min in the control group (n = 285). We could not identify any variables associated with prolongation of the APT or catheter placement failure.

Conclusions: The success rate of the placement was 89.1 % in our academic center. On average, placing the CSC added approximately one additional hour to the APT. This time is not an accurate representation of true catheter placement time, as it included time for preparation of the CSC, TEE, and fluoroscopy. We experienced one documented complication (coronary sinus injury), which was immediately diagnosed by TEE and fluoroscopy in the operating room. No variables associated with prolongation of APT or CSC placement failure were identified.

No MeSH data available.


Related in: MedlinePlus

Percutaneous Coronary Sinus Catheter (Endoplege; Edwards Lifesciences, Irvine, CA). a Retrograde cardioplegia infusion port, b Stylet, c Coronary sinus pressure line, d Balloon infusion port
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Fig1: Percutaneous Coronary Sinus Catheter (Endoplege; Edwards Lifesciences, Irvine, CA). a Retrograde cardioplegia infusion port, b Stylet, c Coronary sinus pressure line, d Balloon infusion port

Mentions: MICS, which required placement of the percutaneous CSC (EndoPlege; Edwards Lifesciences, Irvine, CA) (Fig. 1), was performed by one attending cardiac surgeon at our institution between December 2009 and April 2012. We conducted a retrospective review for all cardiac surgical cases (open heart surgery and MICS) performed by this surgeon during the above period. This study was approved by the University of Iowa Institutional Review Board. The reviewed cardiac cases were divided into two groups: the cardiac cases with the percutaneous CSC placement (CSC group) and the cardiac cases without the percutaneous CSC placement (control group). Anesthesia preparation time (APT), defined as the duration between anesthesia induction and the time the patient was ready for the surgical team, was then compared between the CSC group and the control group. The APT was obtained from our electronic medical record (Epic systems software). The difference between the two groups’ mean APT represents the mean of the additional time required for the percutaneous CSC placement.Fig. 1


Initial experience with percutaneous coronary sinus catheter placement in minimally invasive cardiac surgery in an academic center.

Hanada S, Sakamoto H, Swerczek M, Ueda K - BMC Anesthesiol (2016)

Percutaneous Coronary Sinus Catheter (Endoplege; Edwards Lifesciences, Irvine, CA). a Retrograde cardioplegia infusion port, b Stylet, c Coronary sinus pressure line, d Balloon infusion port
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4940684&req=5

Fig1: Percutaneous Coronary Sinus Catheter (Endoplege; Edwards Lifesciences, Irvine, CA). a Retrograde cardioplegia infusion port, b Stylet, c Coronary sinus pressure line, d Balloon infusion port
Mentions: MICS, which required placement of the percutaneous CSC (EndoPlege; Edwards Lifesciences, Irvine, CA) (Fig. 1), was performed by one attending cardiac surgeon at our institution between December 2009 and April 2012. We conducted a retrospective review for all cardiac surgical cases (open heart surgery and MICS) performed by this surgeon during the above period. This study was approved by the University of Iowa Institutional Review Board. The reviewed cardiac cases were divided into two groups: the cardiac cases with the percutaneous CSC placement (CSC group) and the cardiac cases without the percutaneous CSC placement (control group). Anesthesia preparation time (APT), defined as the duration between anesthesia induction and the time the patient was ready for the surgical team, was then compared between the CSC group and the control group. The APT was obtained from our electronic medical record (Epic systems software). The difference between the two groups’ mean APT represents the mean of the additional time required for the percutaneous CSC placement.Fig. 1

Bottom Line: Patients' characteristics, type of surgery, and transesophageal echocardiography (TEE) findings were compared between the two groups (success group vs. delay/failure group) to identify variables associated with prolongation of the APT or CSC placement failure.The catheter was successfully placed in 74 of those cases.No variables associated with prolongation of APT or CSC placement failure were identified.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesia, University of Iowa Roy J. and Lucille A. Carver College of Medicine, 6JCP, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA.

ABSTRACT

Background: Placement of a percutaneous coronary sinus catheter (CSC) by an anesthesiologist for retrograde cardioplegia in minimally invasive cardiac surgery is relatively safe in experienced hands. However, the popularity of its placement remains limited to a small number of centers due to its perceived complexity and potential complications.

Methods: We retrospectively reviewed all cardiac cases performed by one surgeon between December 2009 and April 2012. The reviewed cases were divided into two groups: cardiac cases with percutaneous CSC placement (CSC group) and cardiac cases without placement (control group). Anesthesia preparation time (APT) was then compared between the CSC group and control group. In the CSC group, cases were further divided into two groups. One group contained cases with an APT of less than 90 min (success group) and the other contained cases with an APT greater than or equal to 90 min or cases with CSC placement failure (delay/failure group). Patients' characteristics, type of surgery, and transesophageal echocardiography (TEE) findings were compared between the two groups (success group vs. delay/failure group) to identify variables associated with prolongation of the APT or CSC placement failure.

Results: Percutaneous CSC placement was required in 83 cases (CSC group). The catheter was successfully placed in 74 of those cases. We experienced one complication, coronary sinus injury after multiple attempts at placing the catheter. The mean APT was 102 ± 31 min in the CSC group (n = 81) and 42 ± 15 min in the control group (n = 285). We could not identify any variables associated with prolongation of the APT or catheter placement failure.

Conclusions: The success rate of the placement was 89.1 % in our academic center. On average, placing the CSC added approximately one additional hour to the APT. This time is not an accurate representation of true catheter placement time, as it included time for preparation of the CSC, TEE, and fluoroscopy. We experienced one documented complication (coronary sinus injury), which was immediately diagnosed by TEE and fluoroscopy in the operating room. No variables associated with prolongation of APT or CSC placement failure were identified.

No MeSH data available.


Related in: MedlinePlus