Hematological Effects of Single Femoral Venous Drainage in Minimally Invasive Mitral Concomitant Tricuspid Valve Surgery

Introduction: With the accruing experience of the single femoral venous drainage (SFVD) technique in reoperative isolated tricuspid valve surgery via a minimally invasive approach, some surgeons applied it to patients undergoing primary surgery. The aim of our study was to evaluate the hematological and clinical effects of SFVD in minimally invasive mitral valve surgery combined with tricuspid annuloplasty. Methods: A total of 99 consecutive patients undergoing minimally invasive mitral valve surgery requiring concomitant tricuspid annuloplasty at our institution between January 2016 and December 2020 were retrospectively analyzed. The patients were divided into two groups according to the different venous drainage strategies: Group S ( n = 53), in which venous drainage via single femoral venous cannulation, and Group D ( n = 46), in which venous drainage via superior vena cava combined with femoral venous cannulations with caval snaring. The postoperative hematological parameters and postoperative complications were compared between the two groups. Multivariate stepwise linear regression was performed to determine whether SFVD independently predicted postoperative hemoglobin drop and operation time. Results: The red blood cell counts, hemoglobin, and hematocrit levels were significantly lower in Group S on arrival at the intensive care unit (ICU) ( p = 0.048; p = 0.009; p = 0.016, respectively), while no significant difference between the two groups on the first postoperative day. Multivariate linear regression indicated that the use of SFVD was independently positively associated with hemoglobin drop ( B = 6.15, 95% CI: 2.47 to 9.83; p = 0.001) and negatively related to the operation time ( B = −21.99, 95% CI: −39.23 to −4.75; p = 0.013). Conclusion: The SFVD technique could shorten the operation time, but it would result in an increased hemoglobin drop on arrival at ICU. However, these changes did not persist postoperatively and were not mirrored in postoperative clinical outcomes.