Two New Drainage Tubes for Minimally Invasive Cardiac Surgery

(#1999-74549 ... May 21, 1999)

Masahiro Endo, MD, Hiroshi Nishida, MD, Yasuko Tomizawa, MD, Shinichiro Kihara, MD, Toru Ishida, MD, and Hitoshi Koyanagi, MD

The Department of Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women's Medical University, Tokyo Japan

ABSTRACT

Background: The limited exposure typical of new minimally invasive surgical approaches to cardiac surgery makes it difficult to utilize traditional equipment such as temporary pacing electrodes or the placement of drainage tubes into the lateral pleural space. To overcome these difficulties, we have developed specialized drainage tubes just for limited access cardiac surgery.

Methods: The first device is a drainage tube with temporary pacing function. It has three fixed electrodes and one free pacing wire incorporated into an elliptical, angled 28 Fr silicone drainage tube. This tube is placed in the space between the heart and the diaphragm. The two fixed electrodes provide epicardial contact for ventricular pacing. The third fixed electrode and one free pacing wire are for the purpose of atrial pacing (Japanese patent #2,701,135). The second device is a Y-shaped drainage tube. Frequently, the pleural space is opened during harvesting of an internal mammary graft and then insertion of a chest tube in the thoracic cavity becomes necessary. We developed a new Y-shaped tube where one segment is placed in the retrosternal space and one segment is placed in the pleural cavity. (Japanese Association of Intellectual Copyright #130,591)

Results: The drainage-pacing device was used in 48 coronary artery bypass grafting (CABG) patients. Drainage function and pacing function were excellent in all patients. The bifurcated drainage device was used in 34 patients achieving effective drainage of both cavities without complication during or after removal.

Conclusions: Due to the limited surgical exposure provided by the newer minimally invasive procedures in cardiac surgery, specialized equipment that can be inserted through small incisions needs to be developed. We report the development of a new drainage-pacing device as well as a bifurcated drain for simultaneous drainage of the mediastinal and pleural cavities. These devices have facilitated minimally invasive cases and were free of complications.

AUTHOR/ARTICLE INFORMATION

Presented at the Second Annual Meeting of the International Society for Minimally Invasive Cardiac Surgery, Palais dés Congres, Paris, France, May 21-22 1999.

Reprint requests to: Masahiro Endo, MD, Department of Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan; Phone: +81-3-3353-8111 ext. 23111; Fax: 81-3-3356-0441

Submitted on: Peer reviewed and accepted at the International Society for Minimally Invasive Cardiac Surgery's 2nd Annual Meeting and Scientific Sessions, Paris, France, May 21-22 1999.

Keywords: Minimally invasive cardiac surgery, Drainage tube with temporary pacing, Y-shaped drainage tube