Single femoral venous drainage versus both vena cava drainage in isolated repeat tricuspid valve surgery

Abstract

To assess the potential advantages of minimally invasive surgery using a single femoral venous drainage method versus femoral venous and superior vena cava or jugular venous drainage method during repeat tricuspid valve surgery. From January 2010 to December 2016, 50 repeat tricuspid valve procedures were performed using a minimally invasive approach without aortic cross-clamping at our institution. The arterial cannula was inserted into the femoral artery, and at the same time, the venous cannula was placed in the femoral vein in 28 patients (FV group) during cardiopulmonary bypass (CPB). The venous cannula was inserted into the femoral vein and the superior vena cava or jugular vein in 22 patients (FSV group). Overall, 36 patients underwent tricuspid valve replacement (TVR) and 14 patients underwent tricuspid val-vuloplasty (TVP). The CPB time and operation time, respectively, were 72.96 ± 25.90 minutes versus 78.59 ± 31.95 minutes (P = 0.495) and 170.75 ± 73.31 minutes versus 228.87 ± 61.45 minutes (P = 0.004) in the FV group versus the FVS group. There were no significant differences in the ventilator-assisted time, the first-day LVEF, and the intensive care unit (ICU) stay between the FV group and the FSV group. Both types of drainage were effective and could ensure safety during the operative procedure. The vacuum-assisted single femoral venous drainage method simplified the minimally invasive isolated repeat tricuspid valve surgical process more significantly and is the more appropriate choice.