Miami Minimally Invasive Valves
Joseph Lamelas, MD
Dedicated to the Advancement of Minimally Invasive Cardiac Surgery
April 16, 2014
Minimally Invasive TVRepair

I have enclosed a You Tube link for a short video on a Minimally Invasive TVRepair.

This is a very simplified approach to either an isolated TVR or concomitant with a MVR.

I do not use a right IJ cannula for SVC drainage.  A long 25 Fr BioMedicus femoral venous cannula is inserted for venous drainage. Once the mini-thoracotomy incision is performed,  2 sump drains are placed through the chest tube incision.  Both cava’s are snared.  The assistant pulls on both snares and the femoral venous cannula is pulled into the IVC.  The right atrium is opened (remember there is a 6 minute safe period inflow occlusion), then the sump suction which was placed via the chest tube incision is placed through the atriotomy into the SVC. The SVC snare is temporarily released during this maneuver. Once the TVRepair is completed, the atriotomy is closed in a 2 layer fashion. Prior to complete closure, the sump drain is removed and the atriotomy completely closed. Both snares are released and the femoral venous cannula is advanced back into the SVC.


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