Application of vacuum-assisted venous drainage in total robotic cardiac surgery

Objective To summarize the experiences in extracorporeal circulation（ECC） with vacuum-assisted venous drainage（VAVD） in total robotic cardiac surgery. Methods ECC was established in 249 patients underwent cardiac surgery with Da Vinci S robotic surgical system in our hospital from January 2007 to August 2011 through the right femoral arterial and venous cannula,and the right internal jugular venous cannula under esophageal ultrasound guidance.VAVD was used during ECC with its pressure controlled at-30--60mmHg. Results The ECC time and aortic cross-clamp time were 40-219（105.9±38.8）min and 21-166（69.5±30.0）min,respectively.During ECC,the urine volume was 100-2 100（771.7±477.6）ml and the ultra-filtration volume was 800-4 800（2 485.4±811.6）ml in 249 patients,the total fluid balance was zero in 16 patients and negative in 189 patients150-2 600（816.6±535.9）ml. Conclusion Peripheral ECC is needed during robotic cardiac surgery.VAVD can ensure sufficient vena cava drainage with its fluid volume reached to zero or negative balance,and is thus a safe and effective technique in robotic cardiac surgery.