Minimally invasive cardiac surgery perfusion guidelines Ramya E., Divya R, Selvam D. Department of Cardiothoracic Surgery, Rajiv Gandhi Government General Hospital, Chennai Online published on 17 October, 2018. Abstract Minimally invasive cardiac surgery is a safe and broadly applicable technique for performing a wide range of complex heart procedures. We have been doing Minimally Invasive Cardiac Surgeries in our institution for the past few years and the results are extremely good. In our institution (Rajiv Gandhi Government General Hospital), over the past one year, we have done about 25 cases of minimally invasive cardiac surgeries, including a spectrum of pathologies from atrial septal defects to Mitral and Aortic valve diseases, which had good short term clinical outcomes and with no perioperative morbidity and mortality. Based on perfusion guidelines we had followed, femoral arterial and venous cannulation was done by Seldinger's technique. In most cases, Right Internal jugular vein cannulation was also done to achieve adequate venous return. Chitwood clamp was used for aortic cross clamping through right third or fourth intercostal space at mid axillary level. Antegrade root cardioplegia was given at the pressure of 100-150mmHg. The average cross clamp time was about 80 minutes and average bypass time was about 130 minutes. The patients were weaned of from bypass with no difficulty. Patients were extubated in 6–8 hours. They had received lesser blood transfusion and showed accelerated recovery. Patients had no CPB associated morbidities. MICS is safe, feasible and we have found that it reduces blood loss, length of stay and showed accelerated recovery. It has greatly improved cosmetic result. Top Keywords Minimally invasive cardiac surgery, femoral cannulation, Chitwood clamp, better cosmoses. Top |