Key result
Internal jugular vein cannulation during cardiopulmonary bypass was associated with a 79.5% incidence of ultrasound-detected thrombi, though all cases remained clinically silent.
Why the study?
The incidence and subsequent complications of internal jugular vein thrombosis following cannulation for cardiopulmonary bypass during minimally invasive cardiac surgery were unknown.
What is the incidence of internal jugular vein thrombosis after cannulation for cardiopulmonary bypass in minimally invasive cardiac surgery?
Observational (n=44)
No
What is the incidence of internal jugular vein thrombosis after cannulation for cardiopulmonary bypass in minimally invasive cardiac surgery?
Internal jugular vein cannulation for cardiopulmonary bypass is associated with a high rate of ultrasound-detected thrombosis (79.5%), but these events appear to be clinically silent without major complications.
High silent thrombus rate after IJ cannulation during CPB should not change practice; leaves open need for prospective trials on clinical relevance.
OBJECTIVES: To determine the incidence and subsequent complications of internal jugular vein (IJV) thrombosis after cannulation performed during cardiopulmonary bypass (CPB) to ensure adequate venous drainage during minimally invasive cardiac surgery. DESIGN: Single-center observational trial SETTINGS: Intensive care postoperative monitoring of cardiac surgery patients and diagnosis of IJV thrombi at a university tertiary hospital during the 13-month study period from December 1, 2022, to January 11, 2024. PARTICIPANTS: 44 patients undergoing catheterization of the IJV for total CPB. INTERVENTION: Structured ultrasound of the IJV at 12 to 16 hours after removing the cannula, in the context of intensive care therapy. MEASUREMENTS & MAIN RESULTS: The incidence of ultrasound-detected IJV thrombi was 79.5%. Thrombi located at the insertion site were smaller compared to those located distally. No major complications were observed during cannula insertion or removal, and none of the patients had clinical symptoms related to IJV thrombi. There were no correlations between cannula size (p = 0.886), intravascular insertion length (p = 0.086), duration of CPB (p = 0.094), or body weight (p = 0.590). CONCLUSIONS: Although IJV thrombosis was frequent, all cases remained clinically silent. These findings suggest that although thrombus formation is common, the risk of symptomatic or obstructive thrombosis may be low. Structured ultrasound follow-up and a risk-adapted anticoagulation strategy, as suggested by recent ESVS guidelines, may optimize postoperative management and outcomes.
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Flinspach et al. (2025) conducted an observational in Minimally invasive cardiac surgery requiring cardiopulmonary bypass (n=44). Internal jugular vein cannulation was evaluated on Incidence of ultrasound-detected internal jugular vein thrombi. Internal jugular vein cannulation during cardiopulmonary bypass was associated with a 79.5% incidence of ultrasound-detected thrombi, though all cases remained clinically silent.
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