Background. Differences in outcome after direct aortic cannulation (AORT) in the chest versus standard femoral arterial cannulation (FEM) have not been defined for minimally invasive cardiac operations utilizing the port-access approach. Methods. A retrospective study was performed of 165 patients undergoing port-access cardiac mitral valve operation (n = 126) or coronary artery bypass grafting (n = 39). In 113 patients, FEM was used, while in 52 patients, AORT was accomplished through a port in the first intercostal space. Results. AORT eliminated endoaortic balloon clamp migration (0/36 [0%] vs 17/95 [18%]), and groin wound or femoral arterial complications (0/52 [0%] vs 11/113 [10%]) without changing procedure times (363 ± 55 vs 355 ±70 minutes). Complications attributable to AORT were injury to the fight internal mammary artery and aortic cannulation site bleeding in 1 patient each. Conclusions. Direct aortic cannulation is technically easy, allows use of an endoaortic clamp, and avoids aorto-iliac arterial disease, the groin incision, and possible femoral arterial injury associated with femoral arterial cannulation. Direct arterial cannulation should expand the pool of patients eligible for port-access operation, and may become the standard for port-access procedures.
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Cardiology and Cardiovascular Medicine