Year : 2012  |  Volume : 15  |  Issue : 2  |  Page : 172--173

Inflow occlusion on beating heart: How long and how?

Orhan Gokalp, Ismail Yurekli, Levent Yilik, Ali Gurbuz 
 Izmir Ataturk Education and Research Hospital, Department of Cardiovascular Surgery, Basin Sitesi, 35360, Izmir, Turkey

Correspondence Address:
Ismail Yurekli
6436 sok 82/3 35540, Karsiyaka-Izmir

How to cite this article:
Gokalp O, Yurekli I, Yilik L, Gurbuz A. Inflow occlusion on beating heart: How long and how?.Ann Card Anaesth 2012;15:172-173

How to cite this URL:
Gokalp O, Yurekli I, Yilik L, Gurbuz A. Inflow occlusion on beating heart: How long and how?. Ann Card Anaesth [serial online] 2012 [cited 2022 May 24 ];15:172-173
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Full Text

The Editor,

Congratulations to the authors reporting on the resection of tricuspid valve with inflow occlusion on beating heart (IOBH) technique. [1] Nowadays, IOBH technique is seldom preferred in cases such as pulmonary valvotomy, aortic valvotomy, atrial septectomy, cardiac injury and extraction of intracardiac thrombus or foreign body. [2],[3] But, there are some issues that should be taken into consideration when using this technique. One of them is the duration of inflow occlusion. It was previously reported that inflow occlusion particularly longer than 3 min may lead to cardiac and neurological complications due to systemic and cerebral malperfusion. [2],[4] In addition, application of occlusion with 45-s intervals and 3-min breaks of normal perfusion in between had good postoperative results. [2]

We think that the IOBH technique should be performed with the aid of a cell saver device that provides a better surgical exposure and limits the need for nonautologous blood transfusion. Consequently, in cases with comorbidity that could complicate cardiopulmonary bypass (CPB), the IOBH technique could be performed successfully by experienced surgical teams using some tools such as autotransfusion equipments.


1Gadhinglajkar S, Sreedhar R, Karunakaran J, Misra M, Somasundaram G, Mathew T. Tricuspid valve excision using off-pump inflow occlusion technique: Role of intra-operative trans-esophageal echocardiography. Ann Card Anaesth 2010;13:148-53.
2Gokalp O, Yurekli I, Yilik L, Bayrak S, Goktogan T, Arikan E, et al. Comparison of inflow occlusion on the beating heart with cardiopulmonary bypass in the extraction of a mass lesion or a foreign body from the right heart. Eur J Cardiothorac Surg 2011;39:689-92.
3Gürbüz A, Yeºil M, Yetkin U, Postaci N, Yürekli I, Arikan E. Giant vegetation on permanent endocavitary pacemaker lead and successful open intracardiac removal. Anadolu Kardiyol Derg 2009;9:249-51.
4Singh J, Dhaliwal RS, Biswal S, Swami N. Inflow occlusion in the era of modern cardiac surgery. J Thorac Cardiovasc Surg 2006;132:1246.