External Aortic Cross-Clamping and Endoaortic Balloon Occlusion in Minimally Invasive Mitral Valve Surgery

Malvindi and colleagues assessed the outcomes of aortic clamping strategies, either transthoracic cross-clamp (TTC, n = 165) or endoaortic balloon occlusion (EAO, n = 93) for patients undergoing minimally invasive mitral valve surgery. Endoaortic balloon occlusion was more commonly used for redo surgery (2% of TTC cases versus 12% of EAO cases). Cerebral stroke was more prevalent in EAO cases than TTC cases (0% versus 4.3%, p = 0.03), although after multivariate adjustment this difference was not significant. There was no difference in aortic dissection rates. The authors determined EAO to be a safe method of cross-clamping, and it is their preferred method for redo procedures.