De-Airing Maneuvers After Minimally Invasive and Robotic-Assisted Intracardiac Procedures

In the setting of minimally invasive and robotic-assisted intracardiac procedures, de-airing requires further technical considerations due to limited access to the pericardial space and the subsequent difficulty of directly manipulating the heart. We summarize the technical steps for de-airing according to different cannulation strategies for minimally invasive and robotic-assisted intracardiac procedures.

Keywords:
Cardiac Surgery; Robotics; Technique; Minimally Invasive; Robotic-Assisted.

Authorship

Andrea Amabile Correspondence Address: Andrea Amabile, https://orcid.org/0000-0003-4689-3871, Division of Cardiac Surgery, Department of Surgery, Yale School of Medicine, 330 Cedar Street, New Haven, Connecticut, United States of America, Zip Code: 06510, E-mail: andrea.amabile@yale.edu

contributions to the conception or design of the work

the acquisition, analysis, or interpretation of data for the work

drafting the work or revising it critically for important intellectual content

final approval

Division of Cardiac Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, United States of AmericaYale School of MedicineUnited States of AmericaNew Haven, Connecticut, United States of AmericaDivision of Cardiac Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, United States of America

https://orcid.org/0000-0003-4689-3871

Arnar Geirsson

contributions to the conception or design of the work

the acquisition, analysis, or interpretation of data for the work

drafting the work or revising it critically for important intellectual content

final approval

Markus Krane

contributions to the conception or design of the work

the acquisition, analysis, or interpretation of data for the work

drafting the work or revising it critically for important intellectual content

final approval

Gianluca Torregrossa

contributions to the conception or design of the work

the acquisition, analysis, or interpretation of data for the work

drafting the work or revising it critically for important intellectual content

final approval

Department of Cardiothoracic Surgery, Lankenau Heart Institute, Lankenau Medical Center, Main Line Health, Wynnewood, Pennsylvania, United States of AmericaLankenau Heart InstituteUnited States of AmericaWynnewood, Pennsylvania, United States of AmericaDepartment of Cardiothoracic Surgery, Lankenau Heart Institute, Lankenau Medical Center, Main Line Health, Wynnewood, Pennsylvania, United States of America

Tommaso Hinna Danesi

contributions to the conception or design of the work

the acquisition, analysis, or interpretation of data for the work

drafting the work or revising it critically for important intellectual content

final approval

Division of Cardiac Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of AmericaUniversity of CincinnatiUnited States of AmericaCincinnati, Ohio, United States of AmericaDivision of Cardiac Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America

Husam H. Balkhy

contributions to the conception or design of the work

the acquisition, analysis, or interpretation of data for the work

drafting the work or revising it critically for important intellectual content

final approval

Division of Minimally Invasive and Robotic Cardiac Surgery, Department of Surgery, University of Chicago Medicine, Chicago, Illinois, United States of AmericaUniversity of Chicago MedicineUnited States of AmericaChicago, Illinois, United States of AmericaDivision of Minimally Invasive and Robotic Cardiac Surgery, Department of Surgery, University of Chicago Medicine, Chicago, Illinois, United States of America

Theo Kofidis

contributions to the conception or design of the work

the acquisition, analysis, or interpretation of data for the work

drafting the work or revising it critically for important intellectual content

final approval

Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre, SingaporeNational University Heart CentreSingaporeSingaporeDepartment of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre, Singapore

Correspondence Address: Andrea Amabile, https://orcid.org/0000-0003-4689-3871, Division of Cardiac Surgery, Department of Surgery, Yale School of Medicine, 330 Cedar Street, New Haven, Connecticut, United States of America, Zip Code: 06510, E-mail: andrea.amabile@yale.edu

This study was carried out at the Yale School of Medicine, New Haven, Connecticut, United States of America.

No conflict of interest.

SCIMAGO INSTITUTIONS RANKINGS

Figures | Tables

Figures (2)
Tables (1)

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Fig. 1
Schematization of the ascending aorta (red) and the aortic cardioplegia cannula (blue) from a caudo-cranial perspective. In normal positioning (left), the cannula enters the ascending aorta with an acute angle. After rotating the patient to his left side (right), the cardioplegia cannula becomes perpendicular to the horizontal plane and thus facilitates the outflow of air bubbles.

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Fig. 2
De-airing steps according to different cannulation strategies. CPB=cardiopulmonary bypass; LV=left ventricular; MV=mitral valve; NSR=normal sinus rhythm; TEE=transesophageal echocardiography.

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Abbreviations, Acronyms & Symbols CPB = Cardiopulmonary bypass LV = Left ventricular MV = Mitral valve NSR = Normal sinus rhythm TEE = Transesophageal echocardiography VF = Ventricular fibrillation

Fig. 1 Schematization of the ascending aorta (red) and the aortic cardioplegia cannula (blue) from a caudo-cranial perspective. In normal positioning (left), the cannula enters the ascending aorta with an acute angle. After rotating the patient to his left side (right), the cardioplegia cannula becomes perpendicular to the horizontal plane and thus facilitates the outflow of air bubbles.

Fig. 2 De-airing steps according to different cannulation strategies. CPB=cardiopulmonary bypass; LV=left ventricular; MV=mitral valve; NSR=normal sinus rhythm; TEE=transesophageal echocardiography.

Abbreviations, Acronyms & Symbols
CPB	= Cardiopulmonary bypass
LV	= Left ventricular
MV	= Mitral valve
NSR	= Normal sinus rhythm
TEE	= Transesophageal echocardiography
VF	= Ventricular fibrillation

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De-Airing Maneuvers After Minimally Invasive and Robotic-Assisted Intracardiac Procedures

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[1] Correspondence Address: Andrea Amabile, https://orcid.org/0000-0003-4689-3871, Division of Cardiac Surgery, Department of Surgery, Yale School of Medicine, 330 Cedar Street, New Haven, Connecticut, United States of America, Zip Code: 06510, E-mail: andrea.amabile@yale.edu