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Mid-term results of peripheric cannulation after port-access surgery

^a Department of Cardiac Surgery, Istanbul Science University, Group Florence Nightingale Hospitals, Abidei Hurriyet Caddesi 290, 34381 Sisli, Istanbul, Turkey
^b Department of Radiology, Istanbul Science University, Group Florence Nightingale Hospitals, Abidei Hurriyet Caddesi 290, 34381 Sisli, Istanbul, Turkey

*Corresponding author. Tel.: +90 532 5641103; fax: +90 212 2398791.

E-mail address: caynakbaris{at}hotmail.com (B. Caynak).

Several minimally invasive approaches, avoiding median sternotomy, have been described within the last few years for cardiac surgery. Femoral arterial and venous cannulation for extracorporeal perfusion are required for many of these operations. The aim of this report is to assess the long-term outcomes of femoral cannulations in patients who underwent minimally invasive procedures. One hundred and sixty patients underwent operations by the port-access method between January 2002 and October 2006. Cardiopulmonary bypass was established by femoral artery-vein cannulation, and a transthoracic clamp was used for the aortic occlusion. One hundred and twenty-one patients were under follow-up in the outpatient clinic and 85 patients underwent Doppler ultrasonography (US) for femoral arterial and venous stenosis. The mean follow-up was 27.9 months (range 1–57 months). There were three hospital mortalities (1.86%), and five late mortalities in this series. The mean follow-up for the Doppler examination was 20.54 months (range 1–56 months). There were two seromas and three wound complications (2.48%), all of which healed after outpatient treatment. All of the flow patterns of the common femoral arteries (CFA) were triphasic except in three of the patients. Three patients (2.48%) were found to have arterial stenosis. One patient with intermittant claudication underwent percutaneous dilatation and stenting of the CFA. Doppler US detected luminal narrowing in two patients who had been having no symptoms, and they are being followed in the outpatient clinic without any complaints. We found a chronic recanalized thrombotic change in the common femoral vein (CFV) in one patient (0.63%). Our study demonstrates vessel patency and/or stenosis in patients without complaints. In conclusion, femoral artery and vein cannulation for port-access surgery with transthoracic clamping can be performed successfully with excellent results in the mid-term.

Key Words: Minimally invasive surgery; Complications; Ultrasound; Vascular disease