1. Percutaneous Coronary Sinus Catheterization With the ProPlege Catheter Under Transesophageal Echocardiography and Pressure Guidance
- Author
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Giuseppe Labriola, Cataldo Labriola, Domenico Paparella, Maurizio Braccio, Pier Paolo Dambruoso, and Francesco Greco
- Subjects
Male ,medicine.medical_specialty ,Cardiac Catheterization ,Percutaneous ,Perforation (oil well) ,Cardiac Catheters ,Minimally invasive cardiac surgery ,Pressure ,Medicine ,Fluoroscopy ,Humans ,Minimally Invasive Surgical Procedures ,Coronary sinus ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Coronary Sinus ,Equipment Design ,Middle Aged ,Surgery ,Catheter ,Anesthesiology and Pain Medicine ,Right heart ,Female ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Complication ,Echocardiography, Transesophageal - Abstract
Objectives Percutaneous catheterization of the coronary sinus (CS) to enable the administration of retrograde cardioplegia may play an important role in minimally invasive cardiac surgery. A new specially designed device (ProPlege; Edwards Lifesciences, Irvine, CA) is described that can be placed under transesophageal echocardiography (TEE) and pressure guidance with a high rate of success and low rate of complications. Design Case series. Setting A university-affiliated private hospital. Participants Patients undergoing minimally invasive cardiac surgery. Interventions The ProPlege device was placed under TEE and pressure guidance only. Measurements and Main Results Records of 70 patients managed with ProPlege were reviewed and analyzed. Successful placement was attained in 69 patients (98.6%) as confirmed by the ventricularization of the CS pressure curve and TEE images. Direct imaging of the ProPlege tip was possible in 34 patients (49.2%). The capacity to generate a CS pressure>30 mmHg during retrograde cardioplegia administration at a flow>150 mL/min was obtained in 64 patients; ProPlege displacement occurred in 5 cases (7.2%). Successful retrograde cardioplegia was delivered in 91.4% of cases. No CS perforation or other injuries to the right heart were noted at intraoperative TEE or direct surgical inspection. Conclusions Percutaneous CS catheterization with ProPlege was performed with a high rate of success for positioning and low complication rate using TEE and pressure guidance only. Further studies are needed to more accurately determine complication rates and to establish the possible complementary role of fluoroscopy.
- Published
- 2014