Clinical application of minimally invasive direct cardiac surgery: 108 cases report
10.3760/cma.j.issn.1001-4497.2012.05.009
- VernacularTitle:直视微创心脏外科手术临床应用108例
- Author:
Bin YOU
;
Feng GAO
;
Yi XU
;
Lili XU
;
Shuo LIU
- Publication Type:Journal Article
- Keywords:
Cardiac surgical procedures;
Surgical procedures,minimally invasive;
Feasibility studies;
Treatment outcome
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2012;28(5):289-293
- CountryChina
- Language:Chinese
-
Abstract:
Objective The aim of this study is to summarize primarily the application range and the clinical effect of the minimally invasive direct cardiac surgery (MIDCS).Methods From April 2010 to August 2011,108 operations had been performed in our centre using MIDCS,among of which 44 males and 64 females,mean age (44.3 ± 16.4 ) years old,mean weight (60.0 ± 12.0 ) kg.These operations included 29 MVR operations (replacement with mechanical valve 19,with tissue valve 10),17 AVR operations( replacement with mechanical valve 11,with tissue valve 6 ),5 MVP operations,6 MVR + AVR operations (replacement with mechanical valve 5,with tissue valve 1 ),12 VSD repair operations and 23 ASD repair operations,9 MIDCAB operations,1 MVR + CABG oparation,2 PECD correction,1 repair of ruptruec chordae tendineae of tricuspid septum and 1 Ebstein deformity correction operation.Concomitant procedures included 19 TVP operations and 11 radiofrequency ablation operations.Except MIDCAB operations,other operations are performed with closed type extracorporeal circulation.Conversion to median sternotomy was necessary in only two patients ( 1.9％ ).Results Mean cardiopulnonary bypass time and aortic eross-clamp time were ( 104.4 ± 59.3 ) minutes and ( 66.7 ± 52.8 ) minutes respectively,74 patients ( 92.5 ％ ) recover to beat automatically after heart ceased operation.Median mechanical ventilation time was ( 14.5 ± 11.9 ) hours,Median intensive care unit stay was ( 18.8 ± 15.3 ) hours,median hospital stay post operative was (6.9 ± 2.9) days.Median incision length was (5.3 ± 1.2 )cm.Median draining volume was( 337.6 ± 240.9 )ml in the first day after operation,No transfusion occurred in 72 patients(66.7％ ).Hospital mortality was 0.No re-exploration for bleeding and sternal wound infection.When leaving hospital,94 being of heart functional class Ⅰ,8 of class Ⅱ,6 of class Ⅲ.Conclusion MIDCS was associated with good operative effect in the near future,superior safety and broad application range.Furthermore MIDCS has minimally invasive,less postoperative bleeding,fewer blood transfusions,good cosmesis,as well as the absence of sternal wound infection.It may be safely performed on selected patients with low postoperative mortality and morbidity.
