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Open Access 01-12-2021 | Visceral Ischemia | Research article

Impact of standardized computed tomographic angiography for minimally invasive mitral and tricuspid valve surgery

Authors: Moritz B. Immohr, Yukiharu Sugimura, Patric Kröpil, Hug Aubin, Jan-Philipp Minol, Alexander Albert, Udo Boeken, Artur Lichtenberg, Payam Akhyari

Published in: Journal of Cardiothoracic Surgery | Issue 1/2021

Abstract

Background

Femoral cannulation for extracorporeal circulation (ECC) is a standard procedure for minimally invasive cardiac surgery (MICS) of the atrio-ventricular valves. Vascular pathologies may cause serious complications. Preoperative computed tomography-angiography (CT-A) of the aorta, axillary and iliac arteries was implemented at our department.

Methods

Between July 2017 and December 2018 all MICS were retrospectively reviewed (n = 143), and divided into 3 groups.

Results

In patients without CT (n = 45, 31.5%) ECC was applied via femoral arteries (91.1% right, 8.9% left). Vascular related complications (dissection, stroke, coronary and visceral ischemia, related in-hospital death) occurred in 3 patients (6.7%). In patients with non-contrast CT (n = 35, 24.5%) only femoral cannulation was applied (94.3% right) with complications in 4 patients (11.4%). CT-angiography (n = 63, 44.1%) identified 12 patients (19.0%) with vulnerable plaques, 7 patients (11.1%) with kinking of iliac vessels, 41 patients (65.1%) with multiple calcified plaques and 5 patients (7.9%) with small femoral artery diameter (d ≤ 6 mm). In 7 patients (11.1%) pathologic findings led to alternative cannulation via right axillary artery, additional 4 patients (6.3%) were cannulated via left femoral artery. Only 2 patients (3.2%) suffered from complications.

Conclusions

CT-A identifies vascular pathologies otherwise undetectable in routine preoperative preparation. A standardized imaging protocol may help to customize the operative strategy.

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Title: Impact of standardized computed tomographic angiography for minimally invasive mitral and tricuspid valve surgery
Authors: Moritz B. Immohr
Yukiharu Sugimura
Patric Kröpil
Hug Aubin
Jan-Philipp Minol
Alexander Albert
Udo Boeken
Artur Lichtenberg
Payam Akhyari
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Visceral Ischemia
Computed Tomography
Heart Surgery
Angiography
Computed Tomography
Heart Surgery
Sternotomy
Pathology
Published in: Journal of Cardiothoracic Surgery / Issue 1/2021
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/s13019-021-01400-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Impact of standardized computed tomographic angiography for minimally invasive mitral and tricuspid valve surgery

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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