Minimally Invasive Port Access Cardiac Surgery TEE Images

provided by Drs Jonathan Kraidin and Enrique Pantin

 

Cardiac surgery now offers port access as a means for aortic and mitral valve surgery. Cardiac anesthesiologists will need to familiarize themselves with the coronary sinus catheter (endoplegia) and endovent catheters. Presented here are some videos from one of my lectures showing several confirmatory views for these catheters.

If you download the app "Anesthesia 411" for the iPhone/iPad or Android phones there are some cases that go over the port access protocols to help you stream-line getting the cases started. Fluoroscopy and TEE images are shown on this app.

 

Zero degree TEE view showing the coronary sinus.

 

Modified bicaval view between 110 and 130 degrees showing a classic double-barrel. The coronary sinus is the one closest to the tricuspid valve in this view.

 

This video sweeps from 0 to 90 degrees, confirming the coronary sinus catheter (endoplegia catheter) is in the coronary sinus.

 

 

TEE image showing retrograde cardioplegia flow during bypass run

 

 

 

TEE image showing the correct position for the endovent catheter. Notice it is just past the bifurcation of the main pulmonary artery. If it is not in enough it will come out during bypass. If it is too far it will not drain properly.