title: Superior vena cava drainage during thoracoscopic cardiac surgery: bilateral internal jugular vein sheaths versus one percutaneous superior vena cava cannula.
abstract: OBJECTIVE
  To evaluate bilateral internal jugular vein sheaths as a replacement of one percutaneous superior vena cava cannula for superior vena cava drainage during thoracoscopic cardiac surgery.
  
  
  METHODS
  A prospective and randomized study.
  
  
  METHODS
  Single cardiovascular institute.
  
  
  METHODS
  Adults undergoing thoracoscopic cardiac surgery.
  
  
  METHODS
  Patients were randomized into a percutaneous superior vena cava cannula group and a bilateral internal jugular vein sheaths group. The superior vena cava drainage for cardiopulmonary bypass was performed with one percutaneous superior vena cava cannula (14-18 Fr) or the bilateral internal jugular vein sheaths (8 Fr).
  
  
  RESULTS
  Both interventions reached theoretic flow rate in all patients. In patients weighing<50 kg (n=38) and 50-70 kg (n=64), the average central venous pressure values during cardiopulmonary bypass of both groups showed no significant differences. The patients weighing>70 kg (n=15) in the bilateral internal jugular vein sheaths group had a normal average central venous pressure value, but it was significantly higher than that of percutaneous superior vena cava cannula group ([10.5±3.1] mmHg vs. [4.5±4.4] mmHg, p=0.013). The patient satisfaction scale scores for the cervical incisions were significantly higher in the bilateral internal jugular vein sheaths group than in the percutaneous superior vena cava cannula group ([2.6±0.9] vs. [2.1±0.8], p=0.002).
  
  
  CONCLUSIONS
  The bilateral internal jugular vein sheaths were a feasible and effective option to replace one percutaneous superior vena cava cannula during thoracoscopic cardiac surgery, with better patient satisfaction.
authors.affiliation: Department of Cardiac Surgery and Anesthesiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, and Guangdong Academy of Medical Sciences, Guangzhou, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Lei
authors.affiliation: Department of Cardiac Surgery and Anesthesiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, and Guangdong Academy of Medical Sciences, Guangzhou, China.
authors.forename: Qing-Shi
authors.initials: QS
authors.lastname: Zeng
authors.affiliation: Department of Cardiac Surgery and Anesthesiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, and Guangdong Academy of Medical Sciences, Guangzhou, China.
authors.forename: Xiao-Shen
authors.initials: XS
authors.lastname: Zhang
authors.affiliation: Department of Cardiac Surgery and Anesthesiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, and Guangdong Academy of Medical Sciences, Guangzhou, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Xie
authors.affiliation: Department of Cardiac Surgery and Anesthesiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, and Guangdong Academy of Medical Sciences, Guangzhou, China.
authors.forename: Zhi-Chao
authors.initials: ZC
authors.lastname: Luo
authors.affiliation: Department of Cardiac Surgery and Anesthesiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, and Guangdong Academy of Medical Sciences, Guangzhou, China. Electronic address: guohuiming_ggh@163.com.
authors.forename: Hui-Ming
authors.initials: HM
authors.lastname: Guo
authors.affiliation: Department of Cardiac Surgery and Anesthesiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, and Guangdong Academy of Medical Sciences, Guangzhou, China.
authors.forename: Ji-Mei
authors.initials: JM
authors.lastname: Chen
authors.affiliation: Department of Cardiac Surgery and Anesthesiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, and Guangdong Academy of Medical Sciences, Guangzhou, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhuang
mesh_terms: D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002315:Cardiopulmonary Bypass; D002405:Catheterization, Central Venous / Q000295:instrumentation*; D057785:Catheters; D002496:Central Venous Pressure; D004322:Drainage / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007432:Intraoperative Period; D007601:Jugular Veins / Q000601:surgery*; D008297:Male; D011446:Prospective Studies; D013906:Thoracoscopy / Q000379:methods*; D014683:Vena Cava, Superior / Q000601:surgery*
keywords: cardiopulmonary bypass; minimally invasive cardiac surgery; superior vena cava