title: Complications Associated With Femoral Cannulation During Minimally Invasive Cardiac Surgery.
abstract: BACKGROUND
  Different types of cannulation techniques are available for minimally invasive cardiac surgery. At our institution, we favor a femoral platform for most minimally invasive cardiac procedures. Here, we review our results utilizing this cannulation approach.
  
  
  METHODS
  We retrospectively reviewed all minimally invasive valve surgeries that were performed at our institution between January 2009 and January 2015. Operative times, lengths of stay, postoperative complications, and mortality were analyzed.
  
  
  RESULTS
  We identified 2,645 consecutive patients. The mean age was 69.7 ± 12.77 years, and 1,412 patients (53.4%) were male. Three hundred fifty-eight patients (13.5%) had a history of cerebrovascular accident, 422 (16%) had previous heart surgery, and 276 (10.4%) had a history of peripheral vascular disease. The procedures performed were isolated aortic valve replacements (42.1%), isolated mitral valve operations (40.6%), tricuspid valve repairs (0.57%), double valve surgery (15%), triple valve surgery (0.3%), and ascending aortic aneurysm resection with and without circulatory arrest (5%). Femoral cannulation and central cannulation were utilized in 2,400 patients (90.7%) and 244 patients (9.3%), respectively. The median aortic cross-clamp time and cardiopulmonary bypass time were 81 minutes (interquartile range, 65 to 105) and 113 minutes (interquartile range, 92 to 142), respectively. The median postoperative hospital length of stay was 6 days (interquartile range, 5 to 9). There were 31 cerebrovascular accidents (1.17%), no aortic dissections, two compartment syndromes, two femoral arterial pseudoaneurysms, and 174 (6.65%) groin wound seromas. The overall 30-day mortality was 57 patients (2.15%).
  
  
  CONCLUSIONS
  Minimally invasive cardiac surgical procedures utilizing femoral cannulation techniques have a low risk of complications.
authors.affiliation: Division of Cardiac Surgery, Mount Sinai Medical Center, Miami Beach, Florida. Electronic address: jlamleasmd@aol.com.
authors.forename: Joseph
authors.initials: J
authors.lastname: Lamelas
authors.affiliation: Division of Cardiac Surgery, Mount Sinai Medical Center, Miami Beach, Florida.
authors.forename: Roy F
authors.initials: RF
authors.lastname: Williams
authors.affiliation: Division of Cardiac Surgery, Mount Sinai Medical Center, Miami Beach, Florida.
authors.forename: Maurice
authors.initials: M
authors.lastname: Mawad
authors.affiliation: Division of Cardiac Surgery, Mount Sinai Medical Center, Miami Beach, Florida.
authors.forename: Angelo
authors.initials: A
authors.lastname: LaPietra
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D002404:Catheterization / Q000379:methods*; D005260:Female; D005263:Femoral Artery; D006351:Heart Valves / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D012189:Retrospective Studies; D020521:Stroke / Q000453:epidemiology / Q000209:etiology