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Chirurgia 2020 December;33(6):285-8

DOI: 10.23736/S0394-9508.19.05061-7


language: English

IntraClude® device: how to predict the balloon volume inflation from our experience analysis

Monica CONTINO 1 , Massimo G. LEMMA 2, Antonietta DELLE FAVE 1, Claudia ROMAGNONI 1, Andrea MANGINI 1, Simone COLOMBO 1, Rubina ROSA 1, Paolo VANELLI 1, Carlo ANTONA 3

1 Cardio-Cerebro-Vascular Department, ASST Fatebenefratelli-Sacco, Milan, Italy; 2 Department of Cardiac Surgery, The Jilin Heart Hospital, Changchun City, China; 3 Università degli Studi di Milano, Milan, Italy

BACKGROUND: IntraClude® Edwards, the endo-balloon for aortic cross-clamping in heart-port procedures, is featured by a new design, resulting in an easier clamping technique. The producer suggests a balloon filling strategy based on an initial volume of 10 mL of saline, followed by additional injections of 2 mL up to complete aortic occlusion. We report a filling procedure based on a relationship between balloon pressure and volume and the size of ascending aorta.
METHODS: From August 2012 to November 2015, 33 patients underwent minimally invasive mitral valve surgery with IntraClude® aid. During the first four procedures, aortic occlusion appeared complete when the balloon pressure was kept above 330 mmHg; an additional 2 mL volume was injected whenever this value got closed to 300 mmHg. We analyzed the final balloon volume and the aortic diameter of each patient within a balloon pressure between 300 and 350 mmHg.
RESULTS: Mean ascending aorta diameter was 31.45±2.12 mm, mean cross-clamping time 120.73±41.01 minutes, mean saline volume inflated 27.73±4.24 mL, mean balloon pressures 340.93±53.74 mmHg. The relationship between ascending aorta diameter and total balloon inflation volume calculated by linear regression was: inflation volume=1.54×ascending aorta diameter -20.81. Statistical analysis showed an R=0.84 (P<0.001), R2=0.7 with an adjusted R2=0.69 and a standard error of estimate=4.06.
CONCLUSIONS: A relationship correlating ascending aorta dimensions and saline volume necessary to reach an effective aortic cross clamp is useful to guarantee a stable occlusion throughout surgery. Additional injections can be required to keep the balloon pressure between the 300 and 350 mmHg.

KEY WORDS: Minimally invasive surgical procedures; Aorta; Pressure

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