Minimally invasive transxiphoid approach to the cardiac apex and caudoventral intrathoracic space.

Abstract

OBJECTIVE: To describe a minimally invasive surgical technique for procedures involving the caudoventral compartment of the thoracic cavity. STUDY DESIGN: Case series. ANIMALS: Dogs (n = 13). METHODS: Thirteen dogs; undergoing epicardial pacemaker implantation (9), palliative pericardial window (2), perforated right ventricle repair with epicardial pacemaker implantation (1), and peritoneopericardial diaphragmatic hernia (1) were operated by a transxiphoid approach. Dogs were positioned in dorsal recumbency and the bony xiphoid process was dissected free of adjoining tissue and transected proximally and distally. The distal transection was proximal to the cartilaginous junction of the process and the diaphragm. Entry to the thoracic cavity without penetration of the abdomen provided access for surgical treatment. RESULTS: All dogs recovered without complication. No dogs required thoracostomy tube placement. CONCLUSIONS: Transxiphoid approach is minimally invasive and provides adequate exposure for disorders of the caudoventral thoracic cavity.