Beyond Conventional Operations: Embracing the Era of Contemporary Minimally Invasive Cardiac Surgery

Ilcheva, Lilly; Risteski, Petar; Tudorache, Igor; Häussler, Achim; Papadopoulos, Nestoras; Odavic, Dragan; Rodriguez Cetina Biefer, Hector; Dzemali, Omer

doi:10.3390/jcm12237210

Cited by 5 publications

(2 citation statements)

References 157 publications

(312 reference statements)

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“…With the rapid development of minimally invasive cardiac surgery, an increasing number of patients have benefited from this approach. The current minimally invasive cardiac approaches include S-shaped partial sternotomy, upper J incision, upper T incision, right parasternal incision, inferior segment sternotomy, and incisions between ribs ( 11 - 14 ). As multiple processes are involved in the Bentall procedure, such as AVR, coronary anastomosis, and ascending aorta replacement, upper sternotomy has become the main incision for this procedure ( 13 ).…”

Section: Discussionmentioning

confidence: 99%

The safety and feasibility of mini-invasive Bentall surgery via right anterior mini-thoracotomy

He,

Guo,

et al. 2024

J Thorac Dis

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Background The right anterior mini-thoracotomy (RAMT) approach has become a popular technique in cardiac surgery and applied in valve surgery. However, there is very limited evidence on the application of RAMT in the Bentall surgery. In the present study, we aimed to evaluate the safety and feasibility of the RAMT approach in Bentall surgery. Methods A retrospective analysis was performed on 27 patients who underwent Bentall surgery between September 2020 and April 2022 in the First Affiliated Hospital of Xi’an Jiaotong University. Follow-ups were undertaken 1 and 6 months after their operations. The baseline, perioperative, and follow-up results were retrospectively analyzed. Results A total of 27 male patients aged 48–61 years were included in the study. The operation time ranged from 4.0 to 5.0 hours, with a median of 4.5 hours. The median aortic cross-clamping time was 122 minutes [interquartile range (IQR): 109–145 minutes], and the median cardiopulmonary bypass (CPB) time was 156 minutes (IQR: 143–183 minutes). The median intensive care unit stay was 3 days (IQR: 1.75–4.25 days). The ventilation time ranged from 6.5 to 22.0 hours, with a median of 13.0 hours. The median drainage volume in the first 24 hours was 210 mL. In the following-up data, no deaths or severe complications were observed. Conclusions The mini-Bentall procedure through an RAMT approach is a feasible and safe approach with few wounds and good clinical results in patients undergoing aortic root replacement.

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Section: Discussionmentioning

confidence: 99%

The safety and feasibility of mini-invasive Bentall surgery via right anterior mini-thoracotomy

He,

Guo,

et al. 2024

J Thorac Dis

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“…For instance, studies comparing hybrid lung resections to traditional open thoracotomies have shown shorter hospital stays, reduced postoperative pain, and quicker recovery times. Additionally, hybrid CABG has emerged as a viable alternative for high-risk patients who may not be suitable candidates for traditional CABG alone, offering improved cardiac function and a lower risk of complications [21].…”

Section: Cardiothoracic Surgerymentioning

confidence: 99%

Innovations in Hybrid Laparoscopic Surgery: Integrating Advanced Technologies for Multidisciplinary Cases

Cheema,

Hassan,

Asim

et al. 2024

Cureus

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Procalcitonin for the diagnosis of postoperative bacterial infection after adult cardiac surgery: a systematic review and meta-analysis

Nicolotti,

Grossi,

Palermo

et al. 2024

Crit Care

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Background and aims Patients undergoing cardiac surgery are subject to infectious complications that adversely affect outcomes. Rapid identification is essential for adequate treatment. Procalcitonin (PCT) is a noninvasive blood test that could serve this purpose, however its validity in the cardiac surgery population is still debated. We therefore performed a systematic review and meta-analysis to estimate the accuracy of PCT for the diagnosis of postoperative bacterial infection after cardiac surgery. Methods We included studies on adult cardiac surgery patients, providing estimates of test accuracy. Search was performed on PubMed, EmBase and WebOfScience on April 12th, 2023 and rerun on September 15th, 2023, limited to the last 10 years. Study quality was assessed with the QUADAS-2 tool. The pooled measures of performance and diagnostic accuracy, and corresponding 95% Confidence Intervals (CI), were calculated using a bivariate regression model. Due to the variation in reported thresholds, we used a multiple-thresholds within a study random effects model for meta-analysis (diagmeta R-package). Results Eleven studies were included in the systematic review, and 10 (2984 patients) in the meta-analysis. All studies were single-center with observational design, five of which with retrospective data collection. Quality assessment highlighted various issues, mainly concerning lack of prespecified thresholds for the index test in all studies. Results of bivariate model analysis using multiple thresholds within a study identified the optimal threshold at 3 ng/mL, with a mean sensitivity of 0.67 (0.47–0.82), mean specificity of 0.73 (95% CI 0.65–0.79), and AUC of 0.75 (IC95% 0.29–0.95). Given its importance for practice, we also evaluated PCT’s predictive capability. We found that positive predictive value is at most close to 50%, also with a high prevalence (30%), and the negative predictive value was always > 90% when prevalence was < 20%. Conclusions These results suggest that PCT may be used to help rule out infection after cardiac surgery. The optimal threshold of 3 ng/mL identified in this work should be confirmed with large, well-designed randomized trials that evaluate the test’s impact on health outcomes and on the use of antibiotic therapy. PROSPERO Registration number CRD42023415773. Registered 22 April 2023. Graphical abstract

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Beyond Conventional Operations: Embracing the Era of Contemporary Minimally Invasive Cardiac Surgery

Cited by 5 publications

References 157 publications

The safety and feasibility of mini-invasive Bentall surgery via right anterior mini-thoracotomy

The safety and feasibility of mini-invasive Bentall surgery via right anterior mini-thoracotomy

Innovations in Hybrid Laparoscopic Surgery: Integrating Advanced Technologies for Multidisciplinary Cases

Procalcitonin for the diagnosis of postoperative bacterial infection after adult cardiac surgery: a systematic review and meta-analysis

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