Optimization of carbon dioxide insufflation strategies in minimally invasive cardiac surgery: the efficacy of continuous insufflation protocols with left ventricular venting

In the context of the minimally invasive modified morrow procedure, continuous CO₂ insufflation significantly reduces microbubble formation and perioperative arrhythmias. Left ventricular venting modality is a key determinant of de-airing efficacy. Protocol optimization should prioritize continuous CO₂ insufflation in combination with left ventricular venting systems to enhance procedural safety.