The Journal of Thoracic and Cardiovascular Surgery
Volume 142, Issue 6 , Pages 1545-1551, December 2011

A novel cardioport for beating-heart, image-guided intracardiac surgery

  • Nikolay V. Vasilyev, MD

      Affiliations

    • Department of Cardiac Surgery, Children’s Hospital Boston and Harvard Medical School, Boston, Mass
    • Corresponding Author InformationAddress for reprints: Nikolay V. Vasilyev, MD, Department of Cardiac Surgery, Children’s Hospital Boston, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115.
    • ,
  • Mitsuhiro Kawata, MD, PhD

      Affiliations

    • Department of Cardiac Surgery, Children’s Hospital Boston and Harvard Medical School, Boston, Mass
    • ,
  • Christopher M. DiBiasio, PhD

      Affiliations

    • Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Mass
    • ,
  • Keith V. Durand, PhD

      Affiliations

    • Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Mass
    • ,
  • Jonathan Hopkins, PhD

      Affiliations

    • Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Mass
    • ,
  • Zachary J. Traina, MS

      Affiliations

    • Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Mass
    • ,
  • Alexander H. Slocum, PhD

      Affiliations

    • Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Mass
    • ,
  • Pedro J. del Nido, MD

      Affiliations

    • Department of Cardiac Surgery, Children’s Hospital Boston and Harvard Medical School, Boston, Mass

Received 29 April 2011; received in revised form 20 June 2011; accepted 11 July 2011. published online 22 August 2011.

Objective

Intracardiac beating-heart procedures require the introduction and exchange of complex instruments and devices. To prevent potential complications such as air embolism and bleeding, a universal cardioport was designed and tested.

Methods

The design consists of a port body and a series of interchangeable sleeves. The port uses a fluid purging system to remove air from the instrument before insertion into the heart, and a valve system minimizes blood loss during instrument changes.

Results

The cardioport was tested ex vivo and in vivo in pigs (n = 5). Beating-heart procedures, such as septal defect closure and mitral valve repair, were modeled. Ex vivo trials (n = 150) were performed, and no air emboli were introduced using the port. In comparison, air emboli were detected in 40% to 85% of the cases without the use of the port-based purging system. Port operation revealed excellent ergonomics and minimal blood loss.

Conclusions

A novel cardioport system designed to prevent air entry and blood loss from transcardiac instrument introduction was shown to be an enabling platform for intracardiac beating-heart surgery. The port system improves safety and facilitates further development of complex instruments and devices for transcardiac beating-heart surgery.

CTSNet classification: 28, 36, 36.2

Abbreviations and Acronyms: 2D, 2-dimensional, 3D, 3-dimensional, VSD, ventricular septal defect

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 This work was supported by the Center for Integration of Medicine and Innovative Technology Award No. 07-026 (to P.J.D.N.), National Institutes of Health National Heart, Lung, and Blood Institute Award No. 5R01HL073647 (to P.J.D.N.), and Massachusetts Technology Transfer Center Award (to P.J.D.N., N.V.V.).

 Disclosures: The equipment and technology used in the study were purchased using academic funds. The authors had full control of the design of the study, methods used, outcome measurements, analysis of data, and production of the written report.

PII: S0022-5223(11)00776-8

doi:10.1016/j.jtcvs.2011.07.041

The Journal of Thoracic and Cardiovascular Surgery
Volume 142, Issue 6 , Pages 1545-1551, December 2011

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