Endovascular Vena Cavae Occlusion Technique in Minimally Invasive Tricuspid Valve Surgery in Patients With Previous Cardiac Surgery

Abstract Objective: The aim of this study is to describe bicaval endovascular occlusion technique in minimally invasive tricuspid valve surgery in patients with previous cardiac surgery. Design: Case series. Setting: Single tertiary University Center. Participants: 10 patients. Interventions: Endovascular occlusion of vena cavae for minimally invasive TV reoperation Measurements: Between 2008 and 2017, 10 patients with previous cardiac surgery underwent tricuspid valve (TV) minimally invasive surgery (repair or replacement; isolated or with concomitant procedures) using CODA balloon catheter (Cook Medical, Indiana, USA) to occlude both vena cavae. Data were retrospectively collected from electronic medical records. Main Results: Superior and inferior vena cava occlusion with CODA balloon catheters was successful with no complications. The drainage of vena cavae was optimal with excellent surgical exposure. CPB time was 131 ± 119 minutes with 30% of patients having aortic clamping (2 with Chitwood clamp, 1 with endoaortic balloon). ICU length of stay was 3.9 ± 2.7 days. In-hospital mortality rate was 30%. Conclusion: Bicaval endovascular occlusion of vena cavae is a feasible and effective technique in patients with previous cardiac surgery who are undergoing a minimally invasive TV procedure. The high mortality rate is associated with the inherent risk of a redo surgery involving the TV.