title: Minimally invasive transxiphoid approach to the cardiac apex and caudoventral intrathoracic space.
abstract: OBJECTIVE
  To describe a minimally invasive surgical technique for procedures involving the caudoventral compartment of the thoracic cavity.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Dogs (n = 13).
  
  
  METHODS
  Thirteen dogs; undergoing epicardial pacemaker implantation (9), palliative pericardial window (2), perforated right ventricle repair with epicardial pacemaker implantation (1), and peritoneopericardial diaphragmatic hernia (1) were operated by a transxiphoid approach. Dogs were positioned in dorsal recumbency and the bony xiphoid process was dissected free of adjoining tissue and transected proximally and distally. The distal transection was proximal to the cartilaginous junction of the process and the diaphragm. Entry to the thoracic cavity without penetration of the abdomen provided access for surgical treatment.
  
  
  RESULTS
  All dogs recovered without complication. No dogs required thoracostomy tube placement.
  
  
  CONCLUSIONS
  Transxiphoid approach is minimally invasive and provides adequate exposure for disorders of the caudoventral thoracic cavity.
authors.affiliation: Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843-4474, USA. dnelson@cvm.tamu.edu
authors.forename: David A
authors.initials: DA
authors.lastname: Nelson
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Miller
authors.forename: Sonya G
authors.initials: SG
authors.lastname: Gordon
authors.forename: Ashley
authors.initials: A
authors.lastname: Saunders
authors.forename: Theresa W
authors.initials: TW
authors.lastname: Fossum
mesh_terms: D000818:Animals; D006348:Cardiac Surgical Procedures / Q000379:methods / Q000662:veterinary*; D004283:Dog Diseases / Q000601:surgery*; D004285:Dogs; D005260:Female; D006331:Heart Diseases / Q000601:surgery / Q000662:veterinary; D006352:Heart Ventricles / Q000473:pathology / Q000601:surgery; D006548:Hernia, Diaphragmatic / Q000662:veterinary; D008297:Male; D010138:Pacemaker, Artificial / Q000662:veterinary*; D010491:Pericardial Window Techniques / Q000662:veterinary