Percutaneous internal jugular vein cannulation for cardiac surgery

Background: In this study, we evaluated the use of percutaneous internal jugular vein cannulation for open cardiac surgeries and reported our experience on the cannulation and the procedure. Methods: Between February 2010 and October 2012, 42 patients (23 males, 19 females; mean age 45 +/- 21.9 years; range 2-82 years) who were operated through percutaneous internal jugular vein cannulation were retrospectively analyzed. An Edwards (R) Fem-Flex II percutaneous femoral artery cannula which was designed for arterial procedures was used. Cannulation was performed percutaneously with the Seldinger technique. Sixteen Fr cannulas were used for adults with a body surface area less than 1.7 m(2), while 18 Fr cannulas were used for patients adults with a body surface area above 1.7 m(2). Minimally invasive cardiac surgery was performed on 25 patients, whereas redo operations were required in 17 patients. Central venous pressure was recorded by cannulae which were advanced through the left internal jugular vein to monitor the adequacy of superior vena cava drainage. Results: No hospital mortality was observed in the study group. Internal jugular venous cannulation was accomplished without a major percutaneous complication in all patients. An additional atrial cannula was inserted following median sternotomy due to displacement of the femoral venous cannula in three patients. There was no significant difference in central vein pressure and vacuum use among the adult patients who were inserted 16 and 18 Fr cannulas. Conclusion: The use of femoral artery cannulas for percutaneous internal jugular vein cannulation is technically easy and can be performed with no serious complications. It also offers adequate superior vena cava drainage and facilitates procedures which require opening of right-sided cardiac structures with peripheral vascular cannulas.