The minimally invasive approach is the direction of cardiac surgery.With the development of telemanipulation and computer technology,the minimally robotic surgery has become reality.As the one of the most minimally invasive cardiac surgery,the robotic surgical system provides cardiac surgeons with less invasive manner and dexterity manipulation.Robotic cardiac surgery is an evolutionary process and has resulted in a substantial increased attention to surgeons and patients.This review is to introduce the recent clinical application of robotic technology in cardiac surgery.

Objective To investigate the effect of non-restrictive external stent on both cell proliferation of rabbit vein grafts and prevention from hyperplasia of the grafts' neointima. Methods 36 New Zealand white rabbits were randomly divided into two groups, each animal was subjected to a reversed autologous venous graft between external jugular vein and common carotid artery. In stenting group (group S), the vein grafts were surrounded by a 6 mm in diameter non-restrictive stent, and in non-stenting group (group NS), there is no stent to support the vein grafts. The grafts were harvested 1 week (1W), 2 weeks (2W) and 4 weeks (4W) after surgery, respectively. The sections were stained with hematoxylin and eosin stain, ?-smooth muscle actin (?-SMA) and proliferating cell nuclear antigen (PCNA) immunocytochemistry stain. PCNA index was calculated in intima, media and adventitia, respectively. Results (1) HE staining: From 1W to 4W, the hyperplasia of intima and media appeared gradually in both group S and group NS, nevertheless such hyperplasia in group S was lessintense than in group NS. (2) ?-SMA staining: Almost all cells in media were positive, but few cells were positive in intima of both groups at 1W; the thickness of intima of both groups increased gradually, and almost all cells except endothelial cells were positive in intima in both groups, though the thickness of intima of group S was smaller than in group NS at 2W and 4W. (3) PCNA index: the index of intima in both two groups peaked at 2W, and the index of intima in group S was less than in group NS at 2W and 4W, P

0.05; at 14 d,28 d, the thickness and area of the intiam in group S were smaller than those in group NS,P

Objective To observe the distribution of different ventricular myocardial band segment's in different echocardiogram sectiones. Methods 5 swine hearts, 5 ox hearts and 5 sheep hearts were dissect to the ventricular myocardial band structure by the standard anatomy method. After the demarcation line of each segment of ventricular myocardial band was defined, they were dyed with different colors and then were recovered into the state before dissecting. At last, they were cut open according to different echocardiogram sectiones. Results With relative stabile anatomy methods, all hearts presented to be a unique integrate myocardial band,with two loops, the basic loop and apical loop, and four segments. At different echocardiogram sectiones, the left ventricle is formed by three muscular strata, while the right ventricle is formed by only one muscular strata. Conclusion The distribution of different ventricular myocardial band segments in different echocanliogram sectiones is significantly different.

Objective To investigate the therapeutic efficacy of surgical treatment of myocardial bridge. Methods Fifteen patients with myocardial bridge had been treated in our hospital from January 1999 to October 2006. Thirteen patients who had typical angina had been treated regularly by medication, but their symptom remission was not satisfactory. One patient suffered from acute myocardial infarction, and another 1 patient complained of palpitation and syncope. All the patients were given surgical treatment. Surgical strategies included minimally invasive off-pump surgery in 9 patients (supraarterial myotomy in 3 patients, coronary artery bypass grafting in 2, and coronary artery bypass grafting with supraarterial myotomy in 4) and on-pump surgery in 6 patients (coronary artery bypass grafting with supraarterial myotomy in 5 patients and supraarterial myotomy in 1). Results All the operations were successfully completed. The operative duration of off-pump and on-pump surgery was 2.8?1.9 h and 3.5?1.7 h, respectively. The extracorporeal circulation time was 59?37 min. No surgery related death or complications occurred. At 3 months after operation, all the patients were free from symptoms, and electrocardiogram returned to normal in 11 patients. During a follow-up for 0.5~7 years (1.9?1.2 years), recurrent palpitation was seen in 1 patient and others reported no angina. Conclusions Surgical treatment of myocardial bridge has good immediate and long-term results.

65mmHg. Sufficient blood products might be indicated when there was excessive oozing. Anticoagulant was not necessary. Two patients died of perioperative myocardial infarction and one of allergic shock to protamine. An incidence of postoperative complications as low as 2 2% (5/225) was obtained. Five patients were found to have various postoperative complications, which were completely cured. All the rest patients were uneventful, and they were discharged after (3 0?2 6) days of stay in the ICU and (8 2?1 5) days after the operation. Therefore, it is our belief that comprehensive and careful postoperative management is essential to achieve excellent results.

To review the experience in surgical management of cor triatriatum, fourteen patients underwent open heart surgery under hypothermic cardiopulmonary bypass (CPB) from 1986 to 2001 for their cor triatiatum were studied retrospectively. The mean age of the patients was 6 6 years, with a range of 1 to 26 years. Eight patients were men and six were women. Eleven cases were diagnosed by two dimensioned echo cardiography with colour Dopplar imaging. Eleven patients with complete cor triatriatum were operate on enlarging ASD, resecting the fiboromuscular membrane and patching ASD and one patient with incomplete cor triatriatum were operated on through similar techniques and the associated abnormalities were corrected at a time. Nine patients were followed up after surgery from 5 months to 15 years, no patient died and had salutary results. It suggested that two dimensional echo cardiography with colour Doppler imaging can diagnose this condition accurately, surgical treatment of cor triatriatum was satisfactory in longterm follow up.

To introduce the experience in application of intra aortic balloon pump (IABP) in coronary artery bypass grafting (CABG), 506 consecutive CABG performed from March 1997 to October 2001 including 19 cases who needed IABP support were retrospectively studied. IABP was inserted through femoral artery when blood circulation failed to maintain normal even though cardiopulmonary bypass had been weaned off and inotropic agents administered. The overall rate of using IABP was 2 4%. IABP was not needed in off pump CABG. Sixteen patients smoothly resuscitated from low output syndrome, but two died of perioperative myocardial infarction (PMI) and one of allergic shock to protamine, resulting in a mortality rate of 15 8%. Two patients (10 5%) were respectively insulted by external iliac artery rupture and thromboembolism of dorsal pedis artery but cured completely. The complication rate was 10 5%. The mean duration of using IABP was 25 3?5 6 hours. The authors hold that IABP should be used without hesitation when indicated and good early outcome and low incidence of complication can always be obtained.

cases of coronary artery bypass grafting (CABG) were analyzed retrospectively. They were divided into four groups. In group 1 ( n =63,1985～1996), group 2 ( n =160, 1997～1999), and group 3 ( n =209, 2000～2002), CABG was performed with cardiopulmonary bypass (CPB). In group 4 ( n =291, 2000～2002) CABG was performed with off pump (OP). The durations of CPB and aortic cross clamp (ACC), temperature, hemodilusion, duration of using ventilator postoperatively, and ICU stay days were analyzed and compared. The patients in the groups 3 and 4 were older than those of the group 1, but younger than group 2. Pre operative supersonic EF value was lower in patients in the group 3 compared with group 2. A tendency of shortening of CPB time and ACC time, raising of temperature, lowering of hemodilusion, and shortening of ventilator time and ICU stay days could be discerned from group 1 down to group 4 ( P

Objective To summarize the experience in diagnosis and surgical treatment of double-chambered right ventricle (DCRV). Methods From 1990 to 2001, 95 patients with DCRV received surgical correction, including 56 males and 39 females, with an age ranging from 1 to 48. 82 cases had other cardiac abnormalities, 56 of whom had ventricular septal defect (VSD). Right atrium incision was made in 8 patients, right ventricular infundibular incision in 30, and both right atriotomy and ventriculotomy in 57. Results Muscular ring was found in 61 patients, and muscular shelf in 34. No death occurred. Preoperatively, 15 patients and 3 patients were misdiagnosed by echocardiography as VSD and pulmonary stenosis, respectively. The diagnosis was corrected during operation. Conclusions DCRV was often found to be complicated with other cardiac disorders. Echocardiography was the main diagnotic method, but the misdiagnosis was not uncommon. So it was very important to make surgical exploration, especially on tricuspid valve and pulmonary valve during intraventricular operations. Right ventricular infundibular incision was convenient and dependable.