Anesthetic Management of Endovascular Cardiopulmonary Bypass System-A Minimally Invasive Approach for Cardiac Surgery with Heartport System.

DOI 6 References
  • IGARASHI Motohiko
    Department of Anesthesiology, Sapporo Medical University School of Medicine
  • NAMIKI Akiyoshi
    Department of Anesthesiology, Sapporo Medical University School of Medicine

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Other Title
  • 血管内人工心肺システムを用いた胸腔鏡下の心臓麻酔　　Ｐｏｒｔ‐Ａｃｃｅｓｓシステムを用いた低侵襲心臓手術の麻酔管理
  • A Minimally Invasive Approach for Cardiac Surgery with Heartport System<sup>TM</sup>
  • Port-Accessシステムを用いた低侵襲心臓手術の麻酔管理

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Abstract

We anesthetised cardiac surgery for replacement of mitral valve replacement and coronary artery bypass graft surgery with endovascular cardiopulmonary bypass system, Heartport SystemTM. The Heartport systemTM is composed of 5 main cannulae and catheters, endoarterial return cannula, endovenous drainage cannula, endovascular aortic clamp catheter, endovascular pulmonaryy artery vent and endovascular coronary sinus catheter.<br>The anesthesia was induced by fentanyl and maintained with isoflurane oxygen air anesthesia. After the endotracheal intubation with BronchocathTM, they were inserted coronary sinus catheter, central venous catheter, pulmonary artery vent from internal jugular vein. The placement of the coronary sinus catheter was confirmed by transesophageal echography and angiography.<br>A common femoral artery and vein were cannulated for femoro-femoral cardio-pulmonary bypass. The surgical procedures were performed under endoscopic surgery, deflating one lung.<br>Cardioplegia was infused through the coronary sinus catheter or from the tip of the arterial cannula placed in the ascending artery by occluding the balloon.<br>After that the surgical procedures were almost the same as that of conventional cardiac surgery by femoro-femoral cardiopulmonary bypass.<br>Cardiac surgery with this system reduced some invasion for the patients by minimizing the surgical woonds, blood loss, infection, post operative pain.<br>We anesthesiologists have to do one lung ventilation, insert three canulae for endovascular cardiopulmonary bypass. It took more time to begin the surgery than the conventional procedure; The time to start surgery must be shortened. We have to pay attention to anatomical difference from patient to patient for the placement of coronary sinus catheter. Cardiac surgery under this endovascular cardio pulmonary bypass reduced surgical woonds, invasion and relieved postoperative pain and is beneficial for the patients.

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