Miami Minimally Invasive Valves
Joseph Lamelas, MD
Dedicated to the Advancement of Minimally Invasive Cardiac Surgery
September 10, 2011
Venous Cannulation and IVC filters

One would think that IVC filters would be a contraindication to insertion of a 25 FR. Biomedicus venous cannula from the femoral vein into the SVC. My initial strategy was to utilize fluoroscopy, identify the IVC filter, and leave the venous cannula right at the level of the filter. Then I would insert another venous cannula into the SVC. I decided to challenge this concept even further. Utilizing fluoroscopy, I passed the wire through the filter and thereafter passed the 25 Fr. cannula through the filter as well into the SVC. I have performed this maneuver on 6 separate occasions, with different types of IVC filters. I have not encountered any difficulties or complications. It leads one to believe how effective these filters really are!!!

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5 thoughts on “Venous Cannulation and IVC filters”

  1. Ken Ung says:

    Do you perform post-op fluoro to check if the IVC filter is still competent?

    1. No, I do not check the filter with flouro after or upon removing the venous cannula. I did do this initially to confirm that it would not dislodge or move upon withdrawing the cannula and found that it does not. I will always use flouro for insertion of the cannula, but never upon removal.

  2. Rick Gaddis says:

    I have an IVC Filter that was placed in 2005. I now have to have Tricuspid repair/replacement surgery due to the valve leaking. My surgeon tells me I have to have traditional Sternotomy because the IVC filter makes it impossible to do a Minimally Invasive procedure. Is there any way for you to get the word out to Cardiac Surgeons across the country about the viability of perfoming Minimally Invasive valve Surgery with IVC filters in place?

    1. There is no doubt that a minimally invasive valve procedure can be performed with an IVC filter in place. I have crossed 4 different types of filters with the venous cannula that is utilized for drainage. Even if one did not want to cross the filter, a venous cannula can be placed right up to the filter by flouro and an additional one placed from above, into the SVC.

      1. huskydad58 says:

        Thanks very much. I have found a surgeon in Plano Texas, Dr Michael Mack that will do the surgery. From what he told me in conference, I believe he is going to utilize the technique you described, going below the filter and then above it, bypassing going through the filter. He said something about putting a port in my neck, and he will perform actual surgery between two ribs on the right side I will post with post-op as to the success of his technique. He will do the surgery at The Heart Hospital in Plano. I hope and pray he knows that this will work.

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