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Ann Thorac Surg 1998;65:1509
© 1998 The Society of Thoracic Surgeons


Correspondence

Reply

Federico J. Benetti, MDa

a Benetti Foundation, M T DE Alvear, 23 23 BS AS, Argentina, 1122

To the Editor

I agree that central cannulation is definitely better than femoral cannulation. When it is possible, my colleagues and I also prefer to cannulate the right atrium and the ascending aorta. In our description of this particular operation, the reason for femoral cannulation was the characteristics of the patient. In this particular technique using video assistance, we enter the left atrium directly. Use of cuffed venous return cannulas is an important contribution.

But the important problem is to find a way to cannulate the patient centrally without increasing the size of the incision and the amount of dissection, avoiding any type of femoral cannulation. I think that the approach is very important to try to improve this type of operation. In addition, another way of perfusion that produces a decreased inflammatory response will be important to make this kind of operation really minimally invasive. The new Cardioview (Vista Cardiothoracic Surgery, Westborough, MA) has been very useful in our experience to decrease the size of the incision and to work in places and angles where it is very difficult to see with only our eyes.

Acknowledgments

Federico J. Benetti is a member of the Advisory Medical and Consulting Board of Vista Cardiothoracic Surgery.





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