Perfusion techniques in minimally invasive setting

Further development and improvement of extracorporeal circulation (ECC) is paramount for the success in ‘minimally invasive cardiac surgery’. This requires advance in underling technology as well as a special mindset and a high level of situation awareness of perfusionist in order to balance safe perfusion and providing optimal conditions for the surgeon to operate. The necessity of this balance influences all stages of preparing and performing the surgical intervention and involve selection of equipment, methods and level of control of patient’s homeostasis and timely compensation for necessary deviations. There are examples presented: selection of heart-lung machine set and cannulation, and a choice of the method of preventing effective heart contraction during minimal invasive cardiac surgery. These examples demonstrate that decisions in minimal invasive setting is often a ‘maze’ choice with impact at all stages of intervention and all specialists involved. The team approach that coordinates efforts of the surgeon, anesthesiologist, perfusionist, and nurses is paramount to achieve the best clinical outcomes.