A New Venous Drainage Technique in Minimally Invasive Redo Tricuspid Surgery: Vacuum-Assist Venous Drainage via a Single Femoral Venous Cannula.

Objective: To summarise the experiences of applying vacuum-assist with a single femoral venous cannula drainage technique in minimally invasive isolated redo tricuspid surgery.

Methods: Eight consecutive patients underwent minimally invasive redo tricuspid surgery through a right thoracotomy at our institute. All of the patients had isolated significant tricuspid regurgitation after previous cardiac surgeries, and received minimally invasive redo tricuspid surgery. The arterial cannula was inserted into the femoral artery, and at the same time, the venous cannula was placed into the femoral vein. The venous cannula was guided by transoesophageal echocardiography and reached the superior vena cava (SVC). The caval veins did not need to be snared with the heart beating during the operation, but applying the vacuum-assisted venous drainage (VAVD) controller was necessary.

Results: This cannulation makes it possible to achieve adequate drainage (3.48±0.44L/min) and accomplishes complete arterial perfusion. Most importantly, it guarantees a good visual field without blood and allows safe surgery. The average time of cardiopulmonary bypass (CPB) was 68.25±13.84min. The length of ICU and hospital stays were 4.13 ±3.52 days and 8.14±4.98 days, respectively. In eight patients, there was no early death in the hospital. One patient experienced acute renal dysfunction.

Conclusion: Vacuum-assist venous drainage via a single femoral venous cannula in isolated redo tricuspid surgery is safe, effective, reliable, and significantly simplifies the procedure.