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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Vandenberghe, Stijn Singjeli, Geni Demertzis, Stefanos |
| Abstract | Objective Space limitations during minimally invasive cardiac surgery impede consistent use of CO2 field-flooding. We compared different gas delivery methods, flow rates and the effect of patient inclination. Methods A gastight model of MICS surgery with internal organs and right thoracotomy wound was created from a mannequin and equipped with a CO2 concentration sensor in the left ventricle. Maximum achievable CO2 concentration was compared for gas delivery via three commercial CO2 diffusors (CarbonMini, Temed, Andocor) and also via a trocar with side port. Gas flow rates of 1, 3, 5 and 8 L per minute were tested. The model was placed either in supine position or with 20° oblique tilt. A simplified transparent model was also created and placed in an optical test bench to evaluate the gas cloud motions via real-time visualization. Results The trocar consistently achieved higher CO2 concentrations inside the left ventricle. At 1 l/min, approximately 2.5 min were needed to fill the supine model to its maximum CO2 concentration, which was limited to a range of 48–82% in the left ventricle. At higher flow rates, filling time and concentration were significantly improved. In a tilted model, all devices and all flow rates generated on average 99% CO2 in the ventricle. Imaging revealed constant gas exchange via the main incision, with CO2 outflow via bottom and air inflow via the top of the incision. Conclusions CO2 field flooding in minimally invasive cardiac surgery is highly effective if the patient is tilted. Else a flow rate of 5 l/min is recommended to achieve the same protection. |
| Related Links | https://cardiothoracicsurgery.biomedcentral.com/counter/pdf/10.1186/s13019-022-01916-5.pdf |
| Ending Page | 9 |
| Page Count | 9 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 17498090 |
| DOI | 10.1186/s13019-022-01916-5 |
| Journal | Journal of Cardiothoracic Surgery |
| Issue Number | 1 |
| Volume Number | 17 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2022-06-22 |
| Access Restriction | Open |
| Subject Keyword | Cardiac Surgery Thoracic Surgery Minimally invasive Field-flooding Carbondioxide Neuroprotection Diffusor |
| Content Type | Text |
| Resource Type | Article |
| Subject | Surgery Cardiology and Cardiovascular Medicine Pulmonary and Respiratory Medicine |
| Journal Impact Factor | 1.5/2023 |
| 5-Year Journal Impact Factor | 1.6/2023 |
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