The Universal Cardiac Introducer for Off-pump, Closed, Beating, Intracardiac Surgery: Proof of Concept

Background: The revival of the off-pump, closed, beating, intracardiac approach requires revisitation of access to, and visualization of the target. We report our experience with the Universal Cardiac Introducer® (UCI) for safe, versatile, intracardiac access. Method: The UCI is comprised of an attachment-cuff and an airlock-introductory chamber to prevent bleeding and air embolism. The utility of the UCI was tested in 13 acute porcine experiments by inserting a Flex 10® microwave probe into the left atrium. Exclusion of the pulmonary vein region was performed using a modifi ed Surgifrost® probe in 7 acute pigs. In 12 acute pigs, an unmodifi ed mitral valve prosthesis was introduced and positioned into the native mitral valve orifi ce. Results: There were no complications associated with cardiac access. The pilot study, using the Flex 10® microwave probe, established the safety of UCI. Unrestricted manipulation of the Surgifrost® resulted in complete exclusion in 6 of 7 animals. The last group showed that a mitral valve prosthesis could be positioned into the mitral valve orifi ce. Conclusion: We conclude that our device can safely and reliably be used to introduce various tools and devices. The feasibility of this approach requires parallel development of image-guidance and virtual reality to substitute for direct vision.