کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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2758934 | 1150144 | 2015 | 6 صفحه PDF | دانلود رایگان |
ObjectiveMinimally invasive techniques commonly are applied to mitral valve surgery; however, there has been little research investigating the optimal methods of cardiopulmonary bypass for the right minithoracotomy approach. Controversy exists as to whether a percutaneous superior vena cava drainage cannula (PSVC) is necessary during these operations. The authors, therefore, sought to determine the effect of using a percutaneous superior vena cava catheter on brain near-infrared spectroscopy, blood lactate levels, hemodynamics and surgical parameters.DesignRandomized, blinded, crossover trial.SettingTertiary care university hospital.ParticipantsPatients undergoing minimally invasive mitral valve surgery via a right minithoracotomy.InterventionsTwenty minutes of either clamped or unclamped percutaneous superior vena cava neck catheter drainage, during mitral valve repair.Measurement and Main ResultsFor the primary outcome of brain near-infrared spectroscopy, there were no differences between the two groups (percutaneous superior vena cava clamped 55.0%±11.6% versus unclamped 56.1%±10.2%) (p = 0.283). For the secondary outcomes pH (clamped 7.35±0.05 versus unclamped 7.37±0.05 p = 0.015), surgical score (clamped 1.96±1.14 versus unclamped 1.22±0.51 p = 0.002) and CVP (clamped 11.6 mmHg±4.8 mmHg versus unclamped 6.1 mmHg±6.1 mmHg p<0.001) were significantly different.ConclusionsThe use of a percutaneous superior vena cava drainage improved surgical visualization and lowered CVP, but had no effect on brain near infrared spectroscopy during minimally invasive mitral valve surgery. (ClinicalTrials.gov Identifier: NCT01166841)
Journal: Journal of Cardiothoracic and Vascular Anesthesia - Volume 29, Issue 1, February 2015, Pages 101–106