Academic Journal

Comparison of Cannulation Strategies for Minimally Invasive Mitral Valve Surgery.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος: Comparison of Cannulation Strategies for Minimally Invasive Mitral Valve Surgery.
Συγγραφείς: Sromicki J; Department of Cardiac Surgery, University Hospital Zurich, CH-8091 Zürich, Switzerland.; Department of Cardiac Surgery, Municipal Hospital Triemli, CH-8063 Zürich, Switzerland., Papadopoulos N; Department of Cardiac Surgery, University Hospital Zurich, CH-8091 Zürich, Switzerland.; Department of Cardiac Surgery, Municipal Hospital Triemli, CH-8063 Zürich, Switzerland., Tröbinger L; Department of Cardiac Surgery, University Hospital Zurich, CH-8091 Zürich, Switzerland.; Department of Cardiac Surgery, Municipal Hospital Triemli, CH-8063 Zürich, Switzerland., Ntinopoulos V; Department of Cardiac Surgery, University Hospital Zurich, CH-8091 Zürich, Switzerland.; Department of Cardiac Surgery, Municipal Hospital Triemli, CH-8063 Zürich, Switzerland., Hebeisen M; Department of Biostatistics, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, CH-8001 Zürich, Switzerland., Milojevic M; Department of Cardiac Surgery, University Hospital Zurich, CH-8091 Zürich, Switzerland., Biefer HRC; Department of Cardiac Surgery, University Hospital Zurich, CH-8091 Zürich, Switzerland.; Department of Cardiac Surgery, Municipal Hospital Triemli, CH-8063 Zürich, Switzerland.; Center for Experimental and Translational Cardiology (CTEC), University of Zürich, CH-8952 Schlieren, Switzerland., Dzemali O; Department of Cardiac Surgery, University Hospital Zurich, CH-8091 Zürich, Switzerland.; Department of Cardiac Surgery, Municipal Hospital Triemli, CH-8063 Zürich, Switzerland.; Center for Experimental and Translational Cardiology (CTEC), University of Zürich, CH-8952 Schlieren, Switzerland.
Πηγή: Interdisciplinary cardiovascular and thoracic surgery [Interdiscip Cardiovasc Thorac Surg] 2026 Jul 01; Vol. 41 (7).
Τύπος έκδοσης: Journal Article; Comparative Study; Multicenter Study
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Oxford University Press Country of Publication: England NLM ID: 9918540787006676 Publication Model: Print Cited Medium: Internet ISSN: 2753-670X (Electronic) Linking ISSN: 2753670X NLM ISO Abbreviation: Interdiscip Cardiovasc Thorac Surg Subsets: MEDLINE
Imprint Name(s): Original Publication: [Oxford, England] : Oxford University Press, [2023]-
Ιατρικοί όροι (MeSH): Mitral Valve*/surgery , Minimally Invasive Surgical Procedures*/adverse effects , Minimally Invasive Surgical Procedures*/methods , Cardiac Catheterization*/adverse effects , Cardiac Catheterization*/mortality , Cardiac Catheterization*/methods , Heart Valve Prosthesis Implantation*/adverse effects , Heart Valve Prosthesis Implantation*/mortality , Heart Valve Prosthesis Implantation*/methods , Catheterization, Peripheral*/adverse effects , Catheterization, Peripheral*/mortality , Catheterization, Peripheral*/methods, Postoperative Complications/etiology ; Postoperative Complications/mortality ; Humans ; Female ; Male ; Aged ; Middle Aged ; Retrospective Studies ; Femoral Artery ; Treatment Outcome ; Risk Factors
Περίληψη: Objectives: Minimally invasive mitral valve surgery (MIV-MVS) continues to evolve through refinements in surgical technique and perioperative management. This study evaluated the association between arterial cannulation strategy and perioperative adverse events.
Methods: Three arterial cannulations were used: central ascending aortic cannulation (AC), open femoral cannulation via groin cutdown (oFC), and percutaneous femoral cannulation (pFC) using pre-closure devices. Patients from 2 centres were assessed for the composite safety end-point of 30-day mortality or stroke, the composite efficacy end-point of all-cause death, stroke, or cannulation-related adverse events, and postoperative delirium. Cannulation-related adverse events included conversion to sternotomy or re-thoracotomy, vessel dissection or bleeding, and cannulation-site infection.
Results: Between January 2013 and January 2020, 823 patients underwent MIV-MVS. Aortic cannulation was performed in 266 patients (32.3%), oFC in 396 (48.1%), and pFC in 161 (19.6%). The composite end-point of 30-day all-cause death or stroke occurred in 19 patients (2.3%) and was similar between AC and FC (odds ratio [OR] 1.16, 95% CI, 0.41-3.16). The extended composite efficacy end-point occurred less frequently with AC than with any FC (OR 0.46, 95% CI, 0.21-0.94), mainly due to fewer access-site complications. Aortic cannulation was also associated with lower odds of perioperative delirium (OR 0.51, 95% CI, 0.29-0.86). No significant difference was observed between oFC and pFC.
Conclusions: In patients undergoing MIV-MVS, 30-day death or stroke was similar across cannulation strategies. Aortic cannulation was associated with a lower rate of cannulation-related complications and less perioperative delirium than FC, largely reflecting fewer access-site complications. Further prospective external validation is warranted.
(© The Author(s) 2026. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.)
Contributed Indexing: Keywords: ascending aorta; cannulation; cardiopulmonary bypass; femoral artery; minimally invasive mitral valve surgery
Entry Date(s): Date Created: 20260701 Date Completed: 20260722 Latest Revision: 20260726
Update Code: 20260726
PubMed Central ID: PMC13390282
DOI: 10.1093/icvts/ivag185
PMID: 42386682
Βάση Δεδομένων: MEDLINE