Extending the use of the pacing pulmonary artery catheter for safe minimally invasive cardiac surgery

J Cardiothorac Vasc Anesth. 2010 Aug;24(4):568-73. doi: 10.1053/j.jvca.2010.01.002. Epub 2010 Mar 25.

Abstract

Objective: In this study, the therapeutic use of pacing pulmonary artery catheters in association with minimally invasive cardiac surgery was evaluated.

Design: A retrospective study.

Settings: A single institutional university hospital.

Participants: Two hundred twenty-four consecutive patients undergoing minimally invasive cardiac surgery through a small (5-cm) right anterolateral thoracotomy using fibrillatory arrest without aortic cross-clamping.

Measurements and main results: Two hundred eighteen patients underwent mitral valve surgery (97%) alone or in combination with other procedures. Six patients underwent other cardiac operations. In all patients, the pacing pulmonary artery catheter was used intraoperatively to induce ventricular fibrillation during the cooling period, and in the postoperative period it also was used in 37 (17%) patients who needed to be paced, mainly for bradyarrhythmias (51%). There were no complications related to the insertion of the catheters. Six (3%) patients experienced a loss of pacing capture, and 2 (1%) experienced another complication requiring the surgical removal of the catheter. Seven (3%) patients needed postoperative implantation of a permanent pacemaker.

Conclusions: In combination with minimally invasive cardiac surgery, pacing pulmonary artery catheters were therapeutically useful to induce ventricular fibrillatory arrest intraoperatively and for obtaining pacing capability in the postoperative period. Their use was associated with a low number of complications.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cardiac Pacing, Artificial / methods
  • Cardiac Pacing, Artificial / trends*
  • Cardiac Surgical Procedures / adverse effects
  • Cardiac Surgical Procedures / methods
  • Cardiac Surgical Procedures / trends*
  • Catheterization, Swan-Ganz / methods
  • Catheterization, Swan-Ganz / trends*
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / adverse effects
  • Minimally Invasive Surgical Procedures / methods
  • Minimally Invasive Surgical Procedures / trends*
  • Postoperative Complications / prevention & control
  • Retrospective Studies
  • Time Factors