Skip to main content
SpringerLink
Log in

A routine de-airing method for total endoscopic robot-assisted mitral valve repair

  • How to Do It
  • Published:
General Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Intraoperative water testing is essential for assessing mitral valve morphology and degree of residual mitral regurgitation during mitral valve repair. However, in some cases, evacuating intracardiac air is challenging. Herein, we report the routine de-airing method during total endoscopic robot-assisted mitral valve repair at our institute and discuss its effectiveness. In brief, our de-airing methods involve the following steps: after restricting the blood flow of the cardiopulmonary bypass, intracardiac air was pushed out into the pulmonary veins by drawing blood from the right ventricle. The left atrium, left ventricle, and ascending aorta were filled with blood to remove air from the root cannula. Retrograde blood flow from the coronary sinus was used to remove air from the coronary arteries. At 10 min after cardiopulmonary bypass weaning, transesophageal echocardiography revealed that residual intracardial air was absent in 99% of patients in all three chambers (ascending aorta, left atrium, and left ventricle).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Landenhed M, Cunha-Goncalves D, Al-Rashidi F, Pierre L, Höglund P, Koul B. Pulmonary collapse alone provides effective de-airing in cardiac surgery: a prospective randomized study. Perfusion. 2016;31:320–6.

    Article  Google Scholar 

  2. Al-Rashidi F, Blomquist S, Höglund P, Meurling C, Roijer A, Koul B. A new de-airing technique that reduces systemic microemboli during open surgery: a prospective controlled study. J Thorac Cardiovasc Surg. 2009;138:157–62.

    Article  Google Scholar 

  3. Tarui T, Ishikawa N, Horikawa T, Seguchi R, Shigematsu S, Kiuchi R, et al. First major clinical outcomes of totally endoscopic robotic mitral valve repair in Japan - a single-center experience. Circ J. 2019;83:1668–73.

    Article  Google Scholar 

  4. Watanabe G, Ishikawa N. Alternative method for cardioplegia delivery during totally endoscopic robotic intracardiac surgery. Ann Thorac Surg. 2014;98:1129–31.

    Article  Google Scholar 

  5. Fishman NH, Carlsson E, Roe BB. The importance of the pulmonary veins in systemic air embolism following open-heart surgery. Surgery. 1969;66:655–62.

    CAS  Google Scholar 

  6. Hoka S, Okamoto H, Yamaura K, Takahashi S, Tominaga R, Yasui H. Removal of retained air during cardiac surgery with transesophageal echocardiography and capnography. J Clin Anesth. 1997;9:457–61.

    Article  CAS  Google Scholar 

  7. Svenarud P, Persson M, van der Linden J. Effect of CO2 insufflation on the number and behavior of air microemboli in open-heart surgery: a randomized clinical trial. Circulation. 2004;109:1127–32.

    Article  CAS  Google Scholar 

  8. Lebon JS, Couture P, Colizza M, Fortier A, Rochon A, Ayoub C, et al. Myocardial protection in minimally invasive mitral valve surgery: retrograde cardioplegia alone using endovascular coronary sinus catheter compared with combined antegrade and retrograde cardioplegia. J Cardiothorac Vasc Anesth. 2019;33:1197–204.

    Article  Google Scholar 

Download references

Funding

None.

Author information

Authors and Affiliations

  1. Department of Anesthesia, New Heart Watanabe Institute, Hamadayama 3-19-11, Suginami-Ku, Tokyo, Japan

    Kazuto Miyata & Sayaka Shigematsu

  2. Department of Cardiovascular Surgery, New Heart Watanabe Institute, Hamadayama 3-19-11, Suginami-Ku, Tokyo, Japan

    Go Watanabe, Takafumi Horikawa, Ryuta Seguchi & Norihiko Ishikawa

Authors
  1. Kazuto Miyata
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Go Watanabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sayaka Shigematsu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Takafumi Horikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ryuta Seguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Norihiko Ishikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kazuto Miyata.

Ethics declarations

Conflict of interest

The authors have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (MPG 3868 KB)

Supplementary file2 (MPG 6576 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Miyata, K., Watanabe, G., Shigematsu, S. et al. A routine de-airing method for total endoscopic robot-assisted mitral valve repair. Gen Thorac Cardiovasc Surg 71, 145–148 (2023). https://doi.org/10.1007/s11748-022-01882-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11748-022-01882-8

Keywords

Search

Navigation