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Ann Thorac Surg 1999;67:864-865
© 1999 The Society of Thoracic Surgeons

How To Do It

Innominate vein cannulation for venous drainage in minimally invasive aortic valve replacement

Amnony Y. Zlotnick, MDa, Michael S. Gilfeather, CCPa, David H. Adams, MDa, Lawrence H. Cohn, MDa, Gregory S. Couper, MDa

a Division of Cardiac Surgery, Brigham and Women’s Hospital, Harvard University Medical School, Boston, Massachusetts, USA

Accepted for publication August 10, 1998.

Address reprint requests to Dr Couper, Division of Cardiac Surgery, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115

Minimally invasive aortic valve or aortic root replacement may be carried out through a mini-hemisternotomy. Venous cannulation of the right atrium may be difficult, at best, and obstruct the limited operative field. We have carried out cannulation of the innominate vein with 25F or 27F thin-walled femoral venous cannulae in 20 patients. Transesophageal echocardiographic guidance is invaluable in safely passing the guidewire and subsequently the cannula into the right atrium. This approach results in an unobtrusive method of complete intrathoracic cannulation through a mini-hemisternotomy with the risks of femoral cannulation.




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