medigraphic.com
ISSN 2448-5640 (Print)
Diario Oficial de la Sociedad Mexicana de Cirugía Cardiaca, A.C., y del Colegio Mexicano de Cirugía Cardiovascular y Torácica, A.C.

2022, Number 1

Next >>

Cir Card Mex 2022; 7 (1)

Minimally Invasive Cardiac Surgery. An Institutional Program

Serrano-Gallardo G, López TAP, Muruato -Ontiveros E, Hidalgo-Vidal J, Martínez-Martínez J, Jasso-Valenzuela G, Chávez-Jiménez E, Álvarez-Rivera MÁ, Rodríguez VM, Muñoz-Hernández MA

Language: English
References: 24
Page: 1-10
PDF size: 345.79 Kb.


ABSTRACT

Minimally invasive cardiac surgery (MICS) has been developed since the nineties. Actually, it is solving the majority of cardiac surgical problems in adults. Material. We present a retrospective study carried out in the Unidad Médica de Alta Especialidad No 71, Instituto Mexicano del Seguro Social, between 2015 and 2019 with 116 patients divided as follows. Group A, with 58 patients treated with MICS, 30 aortic procedures were performed, sixteen mitral procedures, one tricuspid procedure, 6 atrial septal defects repairs, and one pacemaker lead extraction were performed, and finally 4 coronary artery bypass grafting surgeries . Group B, with 58 patients treated with conventional cardiac surgery for complete sternotomy, with similar number of cases, diagnosis and procedures. Results. Both groups showed similarities regarding co-morbidities. However, with a significant difference for smoking (p= 0.022) and hypertension (p=0.009) in Group A. The extracorporeal circulation time in Group A was 112 min and in the Group B of 80 min, respectively (p= 0.00). Aortic clamping in Group A was 92 min and in Group B it was 69 min (p= 0.003). Total postoperative complications were greater in surgery performed by conventional sternotomy (Group B) than in patients operated by MICS (Group A). The post-operative length of stay was shorter in Group A. Conclusions. MICS technique in this study proved to be feasible in our public health system. Minimally invasive surgery showed longer time for extracorporeal circulation and aortic clamping but fewer complications and postoperative length of in-hospital stay.


REFERENCES

  1. Navia JL, Cosgrove DM 3rd. Minimally invasive mitral valve operations. AnnThorac Surg. 1996;62(5):1542-4. doi: 10.1016/0003-4975(96)00779-5.

  2. Cohn LH, Adams DH, Couper GS, Bichell DP, Rosborough DM, Sears SP, et al.Minimally invasive cardiac valve surgery improves patient satisfaction while reducingcosts of cardiac valve replacement and repair. Ann Surg 1997;226(4):421-6; discussion 427-8. doi: 10.1097/00000658-199710000-00003.

  3. Cosgrove DM 3rd, Sabik JF, Navia JL. Minimally invasive valve operations.Ann Thorac Surg 1998;65(6):1535-8; discussion 1538-9. doi: 10.1016/s0003-4975(98)00300-2.

  4. Chitwood WR Jr, Elbeery JR, Chapman WH, Moran JM, Lust RL, Wooden WA,et al. Video-assisted minimally invasive mitral valve surgery: the "micro-mitral"operation. J Thorac Cardiovasc Surg 1997;113(2):413-4. doi: 10.1016/S0022-5223(97)70341-6.

  5. Schmitto JD, Mokashi SA, Cohn LH. Minimally-invasive valve surgery. J AmColl Cardiol 2010;56(6):455-62. doi: 10.1016/j.jacc.2010.03.053.

  6. Rao PN, Kumar AS. Aortic valve replacement through right thoracotomy. TexHeart Inst J 1993;20(4):307-8.

  7. Loulmet DF, Patel NC, Jennings JM, Subramanian VA. Less invasive intracardiacsurgery performed without aortic clamping. Ann Thorac Surg 2008;85(5):1551-5.doi: 10.1016/j.athoracsur.2008.01.071.

  8. Mohr FW, Falk V, Diegeler A, Walther T, van Son JA, Autschbach R. Minimallyinvasive port-access mitral valve surgery. J Thorac Cardiovasc Surg1998;115(3):567-74; discussion 574-6. doi: 10.1016/S0022-5223(98)70320-4.

  9. McGinn JT, Usman Saif, Lapierre H, Pothula VR, Mesana TG, Ruel M. MinimallyInvasaive Coronary Artery Bypass Grafting. Dual-Center Experience in 450 ConsecutivePatients. Circulation 2009;120 [1]:S78-S84. doi.org/10.1161/CIRCULATIONAHA. 108.840041

  10. Lamelas J. Minimally invasive aortic valve replacement: the "Miami Method". AnnCardiothorac Surg 2015;4(1):71-7. doi: 10.3978/j.issn.2225-319X.2014.12.10.

  11. Glauber M, Ferrarini M, Miceli A. Minimally invasive aortic valve surgery: stateof the art and future directions. Ann Cardiothorac Surg 2015;4(1):26-32. doi:10.3978/j.issn.2225-319X.2015.01.01.

  12. Lamelas J, Sarria A, Santana O, Pineda AM, Lamas GA. Outcomes of minimallyinvasive valve surgery versus median sternotomy in patients age 75 years or greater.Ann Thorac Surg 2011;91(1):79-84. doi: 10.1016/j.athoracsur.2010.09.019.

  13. Nguyen TC, Lamelas J. From the ground up: building a minimally invasive aorticvalve surgery program. Ann Cardiothorac Surg 2015;4(2):178-81. doi: 10.3978/j.issn.2225-319X.2015.03.02.FUNDING: NoneDISCLOSURE: The authors have no conflicts of interest todisclose.

  14. Une D, Sakaguchi T. Initiation and modification of minimally invasive coronaryartery bypass grafting. Gen Thorac Cardiovasc Surg 2019;67(4):349-354. doi:10.1007/s11748-018-1050-7.

  15. Lehmann S, Merk DR, Etz CD, Seeburger J, Schroeter T, Oberbach A, et al.Minimally invasive aortic valve replacement: the Leipzig experience. Ann CardiothoracSurg 2015;4(1):49-56. doi: 10.3978/j.issn.2225-319X.2014.11.03.

  16. Glauber M, Miceli A, Canarutto D, Lio A, Murzi M, Gilmanov D, et al. Earlyand long-term outcomes of minimally invasive mitral valve surgery through rightminithoracotomy: a 10-year experience in 1604 patients. J Cardiothorac Surg 2015Dec 7;10:181. doi: 10.1186/s13019-015-0390-y.

  17. Lamelas J. Minimally invasive concomitant aortic and mitral valve surgery:the "Miami Method". Ann Cardiothorac Surg 2015;4(1):33-7. doi: 10.3978/j.issn.2225-319X.2014.08.17.

  18. Alison F. Ward, Eugene A. Grossi, Aubrey C. Galloway Minimally invasive mitralsurgery through right mini-thoracotomy under direct vision. J Thorac Dis2013;5(S6):S673-S679. doi: 10.3978/j.issn.2072-1439.2013.10.09

  19. Glauber M, Miceli A. Minimally invasive aortic valve replacement with suturelessvalve is the appropriate treatment option for high-risk patients and the "realalternative" to transcatheter aortic valve implantation. J Thorac Cardiovasc Surg

  20. 2016;151(3):610-613. doi: 10.1016/j.jtcvs.2015.10.028.20. van der Merwe J, Casselman F, Stockman B, Van Praet F, Beelen R, Maene L, et al.Minimally invasive primary aortic valve surgery: the OLV Aalst experience. AnnCardiothorac Surg 2015;4(2):154-9. doi: 10.3978/j.issn.2225-319X.2015.01.08.

  21. Chu MW, Losenno KL, Fox SA, Adams C, Al-Habib H, Guo R, et al. Clinical outcomesof minimally invasive endoscopic and conventional sternotomy approachesfor atrial septal defect repair. Can J Surg 2014;57(3):E75-81. doi: 10.1503/cjs.012813.

  22. Rodriguez M, Ruel M. Minimally Invasive Multivessel Coronary Surgery and HybridCoronary Revascularization: Can We Routinely Achieve Less Invasive CoronarySurgery? Methodist Debakey Cardiovasc J. 2016;12(1):14-9. doi: 10.14797/mdcj-12-1-14.

  23. Kikuchi K, Une D, Suzuki K, Endo Y, Matsuyama T, Osaka S, Kurata A. Off-PumpMinimally Invasive Coronary Artery Bypass Grafting With a Heart Positioner: DirectRetraction for a Better Exposure. Innovations (Phila) 2015;10(3):183-7. doi:10.1097/IMI.0000000000000167.

  24. Grosner G, Lajos TZ, Schimert G, Bergsland J. Left thoracotomy reoperationfor coronary artery disease. J Card Surg 1990;5(4):304-8. doi: 10.1111/j.1540-8191.1990.tb00758.x.




2020     |     www.medigraphic.com