Left Innominate Vein Cannulation for Mitral Valve Surgery

The authors have been using left innominate vein cannulation for SVC drainage in mitral valve surgery instead of direct cannulation of the SVC or right atrium for more than 20 years. Advantages include improved access to the left atrium with no need for special pericardial retraction stitches for visualization of the entire mitral valve, and improved visualization of the tricuspid valve in procedures undertaken on that valve in isolation or as part of a multiple valve procedure.

There are some particular points to note for successful use of this operative strategy, which are explained in this video. The short video provides a clear demonstration of the operative steps that allow adoption of the method by any experienced cardiac surgeon. This technique has applicability in other situations as well, such as initiating cardiopulmonary bypass in the presence of a large ascending aortic aneurysm, bicaval heart transplantation, and in rare situations where SVC cannulation cannot be achieved in any other way.