Open Seldinger Technique for Peripheral Cannulation Strategy for Minimally Invasive Cardiac Surgery

Objectives:In minimally invasive cardiac surgery, the cannulation strategy significantly affects the outcome of the procedure.In this study, we aimed to evaluate the perioperative outcomes of patients who underwent Seldinger-guided femoro-femoral cannulation for cardiopulmonary bypass. Materials and Methods:This retrospective study included 116 consecutive patients who underwent femoral artery and vein cannulation using the open Seldinger method for various minimally invasive cardiac surgeries between August 2020 and January 2022.Femoral artery-vein cannulation was performed in all patients, and a combination of the femoral and jugular veins was performed in 24 patients.Before femoral exploration, both inguinal regions were evaluated with Doppler ultrasound for calcification, stenosis, and vessel diameter, and the site was selected accordingly.After surgical exposure, both vessel cannulations were performed using only purse-string sutures with the help of a guidewire without incision. Results:Of the patients, 96 (82.8%) had minimally invasive coronary bypass surgery, 12 (10.3%)had mitral valve surgery, 6 (5.2%) had aortic valve surgery, and 2 (1.7%) had tricuspid valve surgery.None of the patients presented with stroke, peripheral arterial ischemia, or deep vein thrombosis.No perioperative vascular injuries or bleeding complications occurred.No deep wound infections or pseudoaneurysms were observed in the early and late postoperative periods.Only two patients underwent primary suturing with superficial skin revision due to impaired superficial wound healing, and two patients had seroma that healed completely with a single puncture.