Innominate vein cannulation for venous drainage in minimally invasive aortic valve replacement

Minimally invasive aortic valve or aortic root replacement may be carried o ut through a mini-hemisternotomy. Venous cannulation of the right atrium ma y be difficult, at best, and obstruct the limited operative field. We have carried out cannulation of the innominate vein with 25F or 27F thin-walled femoral venous cannulae in 20 patients. Transesophageal echocardiographic g uidance is invaluable in safely passing the guidewire and subsequently the cannula into the right atrium. This approach results in an unobtrusive meth od of complete intrathoracic cannulation through a mini-hemisternotomy with the risks of femoral cannulation. (Ann Thorac Surg 1999;67:864-5) (C) 1999 by The Society of Thoracic Surgeons.