Management of extracorporeal circulation for totally robotic assisted cardiac surgery
10.3760/cma.j.issn.1001-4497.2011.07.009
- VernacularTitle:机器人辅助心脏手术的体外循环管理
- Author:
Jiali WANG
;
Changqing GAO
;
Jiachun LI
;
Too ZHANG
;
Lan MA
- Publication Type:Journal Article
- Keywords:
Extracorporeal circulation;
Cardiac surgical proadunes;
Robotics;
Blood gas monitoring
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2011;27(7):407-408
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the way and management of extracorporeal circulation (ECC) for totally robotic assisted cardiac surgery. Methods A Total of 226 patients underwent cardiac surgery using da Vinci S robotic surgical system, including 111 patients underwent atrial septal defect repair ( ASDR) , 9 patients underwent ventricular septal defect repair ( VSDR) ,51 patients underwent mitral valvuloplasty ( MVP) , 20 patients underwent mitral valve replacement( MVR) , 27 patients underwent left atrial myxoma excise and 4 patient underwent right atrial myxoma excise. ECC for most of patients was achieved with femoral arterial cannula, femoral venous cannula and right internal jugular venous cannula, except for 1 patient underwent MVP with femoral arterial cannula and femoral two-stage venous cannula. In all the cases, vacuum-assist venous drainage ( VAVD) , continuous blood gas monitoring and ultrafiltration were used during ECC. myocardial protection was pertic cross-clamp time was 40 ～219 (105.9+38. 8)min and 21 ～166 (69.5±30.0)min respectively. During ECC, the mean urine volume was 100-2100 (771.7±477.6) ml, ultrafiltration volume was 1000-4800 (2495.4 ±811.6) ml, and the total fluid balance was subzero-balanced (172 cases) or zero-balanced(13 cases) in most of patients. Conclusion The establishment of ECC system through peripheral vessels, using VAVD and continuous blood gas monitoring are the key points of ECC for totally robotic assisted cardiac surgery, also certain learning curve of perfusion technique and close communication between the surgical team are essential during ECC.
