Key result
Apical left ventricular venting successfully prevented ventricular dilation and dysfunction during cardiopulmonary bypass in a patient with severe aortic regurgitation.
Case Report (n=1)
Apical left ventricular venting is a viable alternative to prevent ventricular dilation during cardiopulmonary bypass in high-risk redo sternotomy patients with severe aortic insufficiency when standard percutaneous catheters cannot be placed.
Supports preoperative interdisciplinary planning in complex redo surgery with severe AI; leaves open optimal venting alternatives when standard cannulation fails.
Redo cardiac surgery in patients with severe aortic insufficiency can present unique challenges to the anesthesiologist. We report a case highlighting the challenge and importance of interdisciplinary planning between cardiothoracic surgeons and anesthesiologists prior to high-risk surgery. Failure to place an endoaortic balloon and percutaneous coronary sinus catheter due to anatomical abnormalities prompted the adoption of an alternate technique involving apical ventricular venting to assist sternal reentry. Apical left ventricular venting was successfully used to prevent ventricular dilation and dysfunction during institution of cardiopulmonary bypass with significant aortic regurgitation and hypothermia-induced ventricular fibrillation.
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Wakefield et al. (2017) conducted a case report in High-risk redo sternotomy with severe aortic insufficiency (n=1). Apical left ventricular venting was evaluated on Prevention of ventricular dilation and dysfunction during cardiopulmonary bypass. Apical left ventricular venting successfully prevented ventricular dilation and dysfunction during cardiopulmonary bypass in a patient with severe aortic regurgitation.
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