{"title":"微创心脏手术中上腔静脉插管：比经皮颈内静脉引流更好的选择","authors":"Yufei Zhan, Hua Lu, Quan Shi, Shengjie Liao, Tiange Luo, Yipeng Ge, Xiaoshen Zhang","doi":"10.1155/jocs/1277604","DOIUrl":null,"url":null,"abstract":"<div>\n \n <section>\n \n <h3> Backgrounds</h3>\n \n <p>Venous drainage is a critical aspect of peripheral cardiopulmonary bypass (CPB) management in minimally invasive cardiac surgery (MICS), particularly for superior vena cava (SVC) drainage. The most commonly used method for SVC drainage currently is percutaneous cannulation via the internal jugular vein. However, this method still faces challenges in drainage efficiency, cosmetic outcomes, and puncture-related complications. This study aimed to compare the safety, effectiveness, and cosmetic outcomes of direct SVC cannulation (SVCC) and percutaneous internal jugular vein (PIJV) for SVC drainage in MICS.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A retrospective analysis was conducted of patients who underwent MICS with CPB at the Cardiovascular Surgery Department of the First Affiliated Hospital of Jinan University and Guangdong General Hospital between January 2012 and August 2023. In this study, 499 patients underwent SVCC, and 572 patients received PIJV for SVC drainage.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>In the SVCC group, one central venous catheter was mistakenly fixed with a purse-string suture (0.2%). In the PIJV group, complications included neck hematoma in 11 cases (1.9%), puncture site infection in 3 cases (0.5%), and catheter failure in 1 case (0.2%). Significant differences were noted in central venous pressure (CVP) during aortic cross-clamping (<i>p</i> < 0.001), duration of mechanical ventilation (<i>p</i> = 0.049), pleural drainage volume (<i>p</i> = 0.001) and lactate levels at Intensive Care Unit (ICU) admission (<i>p</i> < 0.001) between the two groups. Additionally, lactate levels were significantly different only in the subgroup of patients weighing > 50 kg. Patients with a CVP ≤ 0 mmHg during aortic cross-clamping exhibited lower lactate levels on ICU admission than those with CVP > 0 mmHg.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>SVCC in MICS provides an easy and safe method with minimal complications, improved venous drainage, and better cosmetic results than the PIJV method.</p>\n </section>\n </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3000,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/1277604","citationCount":"0","resultStr":"{\"title\":\"Superior Vena Cava Canulation During Minimally Invasive Cardiac Surgery: A Better Choice than Percutaneous Internal Jugular Vein for Venous Drainage\",\"authors\":\"Yufei Zhan, Hua Lu, Quan Shi, Shengjie Liao, Tiange Luo, Yipeng Ge, Xiaoshen Zhang\",\"doi\":\"10.1155/jocs/1277604\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n <section>\\n \\n <h3> Backgrounds</h3>\\n \\n <p>Venous drainage is a critical aspect of peripheral cardiopulmonary bypass (CPB) management in minimally invasive cardiac surgery (MICS), particularly for superior vena cava (SVC) drainage. The most commonly used method for SVC drainage currently is percutaneous cannulation via the internal jugular vein. However, this method still faces challenges in drainage efficiency, cosmetic outcomes, and puncture-related complications. This study aimed to compare the safety, effectiveness, and cosmetic outcomes of direct SVC cannulation (SVCC) and percutaneous internal jugular vein (PIJV) for SVC drainage in MICS.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>A retrospective analysis was conducted of patients who underwent MICS with CPB at the Cardiovascular Surgery Department of the First Affiliated Hospital of Jinan University and Guangdong General Hospital between January 2012 and August 2023. In this study, 499 patients underwent SVCC, and 572 patients received PIJV for SVC drainage.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>In the SVCC group, one central venous catheter was mistakenly fixed with a purse-string suture (0.2%). In the PIJV group, complications included neck hematoma in 11 cases (1.9%), puncture site infection in 3 cases (0.5%), and catheter failure in 1 case (0.2%). Significant differences were noted in central venous pressure (CVP) during aortic cross-clamping (<i>p</i> < 0.001), duration of mechanical ventilation (<i>p</i> = 0.049), pleural drainage volume (<i>p</i> = 0.001) and lactate levels at Intensive Care Unit (ICU) admission (<i>p</i> < 0.001) between the two groups. Additionally, lactate levels were significantly different only in the subgroup of patients weighing > 50 kg. Patients with a CVP ≤ 0 mmHg during aortic cross-clamping exhibited lower lactate levels on ICU admission than those with CVP > 0 mmHg.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>SVCC in MICS provides an easy and safe method with minimal complications, improved venous drainage, and better cosmetic results than the PIJV method.</p>\\n </section>\\n </div>\",\"PeriodicalId\":15367,\"journal\":{\"name\":\"Journal of Cardiac Surgery\",\"volume\":\"2025 1\",\"pages\":\"\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-10-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/1277604\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Cardiac Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1155/jocs/1277604\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cardiac Surgery","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1155/jocs/1277604","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Superior Vena Cava Canulation During Minimally Invasive Cardiac Surgery: A Better Choice than Percutaneous Internal Jugular Vein for Venous Drainage
Backgrounds
Venous drainage is a critical aspect of peripheral cardiopulmonary bypass (CPB) management in minimally invasive cardiac surgery (MICS), particularly for superior vena cava (SVC) drainage. The most commonly used method for SVC drainage currently is percutaneous cannulation via the internal jugular vein. However, this method still faces challenges in drainage efficiency, cosmetic outcomes, and puncture-related complications. This study aimed to compare the safety, effectiveness, and cosmetic outcomes of direct SVC cannulation (SVCC) and percutaneous internal jugular vein (PIJV) for SVC drainage in MICS.
Methods
A retrospective analysis was conducted of patients who underwent MICS with CPB at the Cardiovascular Surgery Department of the First Affiliated Hospital of Jinan University and Guangdong General Hospital between January 2012 and August 2023. In this study, 499 patients underwent SVCC, and 572 patients received PIJV for SVC drainage.
Results
In the SVCC group, one central venous catheter was mistakenly fixed with a purse-string suture (0.2%). In the PIJV group, complications included neck hematoma in 11 cases (1.9%), puncture site infection in 3 cases (0.5%), and catheter failure in 1 case (0.2%). Significant differences were noted in central venous pressure (CVP) during aortic cross-clamping (p < 0.001), duration of mechanical ventilation (p = 0.049), pleural drainage volume (p = 0.001) and lactate levels at Intensive Care Unit (ICU) admission (p < 0.001) between the two groups. Additionally, lactate levels were significantly different only in the subgroup of patients weighing > 50 kg. Patients with a CVP ≤ 0 mmHg during aortic cross-clamping exhibited lower lactate levels on ICU admission than those with CVP > 0 mmHg.
Conclusion
SVCC in MICS provides an easy and safe method with minimal complications, improved venous drainage, and better cosmetic results than the PIJV method.
期刊介绍：
Journal of Cardiac Surgery (JCS) is a peer-reviewed journal devoted to contemporary surgical treatment of cardiac disease. Renown for its detailed "how to" methods, JCS''s well-illustrated, concise technical articles, critical reviews and commentaries are highly valued by dedicated readers worldwide.
With Editor-in-Chief Harold Lazar, MD and an internationally prominent editorial board, JCS continues its 20-year history as an important professional resource. Editorial coverage includes biologic support, mechanical cardiac assist and/or replacement and surgical techniques, and features current material on topics such as OPCAB surgery, stented and stentless valves, endovascular stent placement, atrial fibrillation, transplantation, percutaneous valve repair/replacement, left ventricular restoration surgery, immunobiology, and bridges to transplant and recovery.
In addition, special sections (Images in Cardiac Surgery, Cardiac Regeneration) and historical reviews stimulate reader interest. The journal also routinely publishes proceedings of important international symposia in a timely manner.
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