title: A novel cardioport for beating-heart, image-guided intracardiac surgery.
abstract: OBJECTIVE
  Intracardiac beating-heart procedures require the introduction and exchange of complex instruments and devices. To prevent potential complications such as air embolism and bleeding, a universal cardioport was designed and tested.
  
  
  METHODS
  The design consists of a port body and a series of interchangeable sleeves. The port uses a fluid purging system to remove air from the instrument before insertion into the heart, and a valve system minimizes blood loss during instrument changes.
  
  
  RESULTS
  The cardioport was tested ex vivo and in vivo in pigs (n = 5). Beating-heart procedures, such as septal defect closure and mitral valve repair, were modeled. Ex vivo trials (n = 150) were performed, and no air emboli were introduced using the port. In comparison, air emboli were detected in 40% to 85% of the cases without the use of the port-based purging system. Port operation revealed excellent ergonomics and minimal blood loss.
  
  
  CONCLUSIONS
  A novel cardioport system designed to prevent air entry and blood loss from transcardiac instrument introduction was shown to be an enabling platform for intracardiac beating-heart surgery. The port system improves safety and facilitates further development of complex instruments and devices for transcardiac beating-heart surgery.
authors.affiliation: Department of Cardiac Surgery, Children's Hospital Boston and Harvard Medical School, Boston, MA 02115, USA. nikolay.vasilyev@childrens.harvard.edu
authors.forename: Nikolay V
authors.initials: NV
authors.lastname: Vasilyev
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Kawata
authors.forename: Christopher M
authors.initials: CM
authors.lastname: DiBiasio
authors.forename: Keith V
authors.initials: KV
authors.lastname: Durand
authors.forename: Jonathan
authors.initials: J
authors.lastname: Hopkins
authors.forename: Zachary J
authors.initials: ZJ
authors.lastname: Traina
authors.forename: Alexander H
authors.initials: AH
authors.lastname: Slocum
authors.forename: Pedro J
authors.initials: PJ
authors.lastname: del Nido
mesh_terms: D000818:Animals; D006348:Cardiac Surgical Procedures / Q000295:instrumentation*; D047549:Coronary Artery Bypass, Off-Pump; D019560:Echocardiography, Three-Dimensional; D019723:Endoscopes; D066298:In Vitro Techniques; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation; D009200:Myocardial Contraction; D034421:Sus scrofa