Superior vena cava drainage during thoracoscopic cardiac surgery: Bilateral internal jugular vein sheaths versus one percutaneous superior vena cava cannula

摘要

Objective To evaluate bilateral internal jugular vein sheaths as a replacement of one percutaneous superior vena cava cannula for superior vena cava drainage during thoracoscopic cardiac surgery. Design A prospective and randomized study. Setting Single cardiovascular institute. Participants Adults undergoing thoracoscopic cardiac surgery. Interventions Patients were randomized into a percutaneous superior vena cava cannula group and a bilateral internal jugular vein sheaths group. The superior vena cava drainage for cardiopulmonary bypass was performed with one percutaneous superior vena cava cannula (14-18 Fr) or the bilateral internal jugular vein sheaths (8 Fr). Measurements and Main Results Both interventions reached theoretic flow rate in all patients. In patients weighing<50 kg (n = 38) and 50-70 kg (n = 64), the average central venous pressure values during cardiopulmonary bypass of both groups showed no significant differences. The patients weighing>70 kg (n = 15) in the bilateral internal jugular vein sheaths group had a normal average central venous pressure value, but it was significantly higher than that of percutaneous superior vena cava cannula group ([10.5齗 mmHg vs. [4.5齗 mmHg, p = 0.013). The patient satisfaction scale scores for the cervical incisions were significantly higher in the bilateral internal jugular vein sheaths group than in the percutaneous superior vena cava cannula group ([2.6齗 vs. [2.1齗, p = 0.002). Conclusions The bilateral internal jugular vein sheaths were a feasible and effective option to replace one percutaneous superior vena cava cannula during thoracoscopic cardiac surgery, with better patient satisfaction.