HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Antonio F. Corno Judith Horisberger Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Corno, A. F. Articles by von Segesser, L. K. Search for Related Content PubMed PubMed Citation Articles by Corno, A. F. Articles by von Segesser, L. K. Related Collections Congenital - acyanotic Congenital - cyanotic Extracorporeal circulation Valve disease

Eur J Cardiothorac Surg 2004;26:219-220
© 2004 Elsevier Science NL

How-to-do-it

Right atrial surgery with unsnared inferior vena cava

Department of Cardiovascular Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), 46 rue du Bugnon, CH-1011 Lausanne, Switzerland

Received 20 November 2003; received in revised form 6 January 2004; accepted 8 March 2004.

^* Corresponding author. Tel.: +41-21-314-2280; fax: +41-21-314-2278
e-mail: antonio.corno{at}chuv.hospvd.ch

Right atrial procedures require snaring the venous cannulas to prevent air entrapment in the venous line. In particular situations with complex congenital morphology and/or presence of severe pericardial adhesions the right atrial opening without the inferior vena cava cannula in the surgical field and without dissecting and snaring the inferior vena cava itself, might substantially facilitate the surgical technique, provided an adequate venous drainage is assured to avoid flow reduction or circulatory arrest. In several patients with congenital or acquired heart disease with potentially complicated venous drainage, like extracardiac Fontan procedure and tricuspid valve replacement, cardiopulmonary bypass was conducted either on normothermia (congenital lesions) or with mild hypothermia (acquired disease), with 3 l/min per m² flow index and venous drainage through femoral vein cannulation. The right atrium was opened without snaring the inferior vena cava, never provoking reduction of the venous drainage nor air locks in the venous line. This approach substantially enhanced the surgical exposure and therefore facilitated the operative technique without any negative consequence to the patients. Right atrial surgery on cardiopulmonary bypass without direct cannulation and snaring of both superior and inferior vena cava is feasible without flow reduction for surgeons taking care of both congenital and acquired cardiac lesions.

Key Words: Cardiopulmonary bypass • Cavopulmonary connection • Fontan procedure • Inferior vena cava • Tricuspid valve repair • Tricuspid valve replacement

This article has been cited by other articles:

				M. Murzi, E. Kallushi, K. K. Tiwari, A. G. Cerillo, S. Bevilacqua, J. H. Karimov, M. Solinas, and M. Glauber Minimally invasive mitral valve surgery through right thoracotomy in patients with patent coronary artery bypass grafts Interactive CardioVascular and Thoracic Surgery, July 1, 2009; 9(1): 29 - 32. [Abstract] [Full Text] [PDF]

				A. F. Corno Systemic venous drainage: can we help Newton? Eur. J. Cardiothorac. Surg., June 1, 2007; 31(6): 1044 - 1051. [Abstract] [Full Text] [PDF]

				L. K. von Segesser Peripheral cannulation for cardiopulmonary bypass MMCTS, October 9, 2006; 2006(1009): 1610. [Abstract] [Full Text] [PDF]

				Y. Tanoue, M. Masuda, M. Eto, and R. Tominaga Venous cannulation for extracorporeal circulation after total cavopulmonary connection with extracardiac conduit Interactive CardioVascular and Thoracic Surgery, February 1, 2006; 5(1): 9 - 10. [Abstract] [Full Text] [PDF]