{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T03:18:36Z","timestamp":1783567116955,"version":"3.55.0"},"reference-count":21,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T00:00:00Z","timestamp":1709251200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Innovations&amp;#65533;(Phila)"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Lower-limb ischemia is a complication of minimally invasive cardiac surgery with femoral cannulation. Herein, we verified our strategy using distal perfusion cannulation (DPC) against this complication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We retrospectively assessed 91 cases of aortic valve replacement with femoral cannulation between January 2019 and March 2023. DPC was applied when lower-limb tissue oxygenation index declined by \u226520%. The cannula to femoral artery diameter ratio (C\/FA) was calculated by dividing the cannula size (Fr) divided by 3 by the femoral artery inner diameter (mm). Postoperative maximum creatinine kinase (CK\n                      <jats:sub>max<\/jats:sub>\n                      ), lactate dehydrogenase (LDH\n                      <jats:sub>max<\/jats:sub>\n                      ), and lactate levels were analyzed, and univariable logistic regression and receiver operating characteristic curve analyses were employed to determine DPC predictors and the cutoff C\/FA for DPC, respectively. Patients without DPC were divided into 2 subgroups based on the cutoff C\/FA for further comparisons.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      DPC was required in 9 patients. Symptomatic ischemia was not observed. All laboratory data were similar in the DPC and non-DPC groups. C\/FA was significantly associated with DPC (odds ratio = 1.27, 95% confidence interval: 1.09 to 1.47,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.002), and the cutoff C\/FA was 0.70 (sensitivity = 0.89, specificity = 0.80). In the non-DPC group, CK\n                      <jats:sub>max<\/jats:sub>\n                      (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.027) and LDH\n                      <jats:sub>max<\/jats:sub>\n                      (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.041) were significantly higher in patients with C\/FA \u22650.7 (\n                      <jats:italic>n<\/jats:italic>\n                      = 16) than in those with C\/FA &lt;0.7 (\n                      <jats:italic>n<\/jats:italic>\n                      = 66).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Our strategy for preventing symptomatic ischemia is reasonable and could be almost achieved without DPC when C\/FA is &lt;0.7. C\/FA also predicts asymptomatic potential ischemia, and proactive DPC is preferable when C\/FA is \u22650.7.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15569845241237212","type":"journal-article","created":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T00:33:01Z","timestamp":1710894781000},"page":"161-168","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Cannula to Femoral Artery Diameter Ratio Predicts Potential Lower-Limb Ischemia in Minimally Invasive Cardiac Surgery With Femoral Cannulation"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3813-8748","authenticated-orcid":false,"given":"Takuya","family":"Nishijima","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Kyushu University Hospital, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9683-2706","authenticated-orcid":false,"given":"Tomoki","family":"Ushijima","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Kyushu University Hospital, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshifumi","family":"Fuke","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Kyushu University Hospital, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meikun","family":"Kan-o","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Kyushu University Hospital, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Kimura","sequence":"additional","affiliation":[{"name":"Advanced Aortic Therapeutics, Faculty of Medicine, Kyushu University Graduate School of Medicine, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromichi","family":"Sonoda","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Kyushu University Hospital, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0865-0169","authenticated-orcid":false,"given":"Akira","family":"Shiose","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Kyushu University Hospital, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,3,19]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0267659118768151"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000000858"},{"key":"e_1_3_3_4_2","article-title":"Compartment syndrome following minimally invasive mitral valve repair: a case report","volume":"10","author":"Bui VD","year":"2022","unstructured":"Bui VD, Le MM, Nguyen D, et al. 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