title: Venous drainage method for cardiopulmonary bypass in single-access minimally invasive cardiac surgery: siphon and vacuum-assisted drainage.
abstract: Vacuum-assisted venous drainage (VAVD) can facilitate venous drainage in single-access minimally invasive cardiac surgery (SAMICS). We retrospectively examined the use of VAVD in SAMICS in our hospital for this report. VAVD has been performed according to a VAVD protocol since 2000. Data from the 110 patients who underwent SAMICS in our institute from January 2000 to June 2002 were reviewed retrospectively. The total negative pressure was maintained at no greater than -90 mmHg. Indications for use of VAVD (protocol) were: insufficient venous return by siphon drainage alone, persistent elevation of the central venous pressure (CVP), and, insufficient venous drainage in the operative field. Of 110 patients, 97 (88.2%) underwent VAVD. The body surface area was significantly smaller in the group that did not require VAVD (the non-VAVD group) than in the group that did (VAVD group) (VAVD group versus non-VAVD group: 1.586 +/- 0.175 versus 1.408 +/- 0.153 m(2), P < 0.001). Other factors such as cardiopulmonary bypass time, aortic cross-clamp time, postoperative maximum lactate dehydrogenase, postoperative maximum creatinine, postoperative maximum blood urea nitrogen were similar in the two groups. VAVD is necessary in SAMICS except for small patients. A VAVD total negative pressure of -90 mmHg did not hinder operative procedures or cause clinical problems.
authors.affiliation: Department of Cardiovascular Surgery, Misatokennwa Hospital, Misato, Saitama 341-8555, Japan. nomurai@agate.plala.or.jp
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Murai
authors.forename: Mamiko
authors.initials: M
authors.lastname: Cho
authors.forename: Shuichi
authors.initials: S
authors.lastname: Okada
authors.forename: Tomohumi
authors.initials: T
authors.lastname: Chiba
authors.forename: Masahito
authors.initials: M
authors.lastname: Saito
authors.forename: Souichi
authors.initials: S
authors.lastname: Shioguchi
authors.forename: Shigeyoshi
authors.initials: S
authors.lastname: Gon
authors.forename: Ikkoku
authors.initials: I
authors.lastname: Hata
authors.forename: Naoya
authors.initials: N
authors.lastname: Yamauchi
authors.forename: Takao
authors.initials: T
authors.lastname: Imazeki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D004322:Drainage / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006331:Heart Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome; D014680:Veins / Q000601:surgery*