Minimally Invasive ASD Repair: Step-by-Step Guide

What about cardioplegia? What way did you use? And aortic clamp placement? Thanks

Thank you Dr. Carlos Troconis. I use Del Nido Cardioplegia (1:4 ratio) and am comfortable going up to 90 minutes without redosing. Almost all adult patients will get 1000cc. We can probably get away with longer. If at 50 minutes I feel I can finish within the next 20 minutes, then I do not redose. If at 50 minutes I feel like I need MORE than 20 minutes, I will usually give an additional 200-300cc and this will buy me an additional 45 minutes or so. There's obviously not a lot of data or science behind this and you'll get different responses but this has worked for me. For cross-clamp, I use a flexible Navarro cross clamp through the incision. An alternative is Chitwood through a separate incision or endoballoon. Hope that helps.

Thank you for this video, Dr. Nguyen. What is your opinion about using induced ventricular fibrillation instead of aortic cross-clamping and cardioplegia? Have you ever used right midaxillary thoracotomy with transthoracic aortic and venous cannulas placement in your practice? Thank you!