Cirurgia cardíaca videoassistida

Júnior, Jeronimo Antonio Fortunato; Pereira, Marcelo Luiz; Martins, André Luiz M.; Pereira, Daniele de Souza C.; Paz, Maria Evangelista; Paludo, Luciana; Filho, Alcides Branco; Milosewich, Branka

doi:10.5935/1678-9741.20120006

Cited by 4 publications

(3 citation statements)

References 40 publications

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“…Em relação às técnicas de CRM, a minimamente invasiva ocorre em maior tempo cirúrgico, porém com recuperação na fase hospitalar mais rápida, independentemente do acesso e da doença tratada, e com menores comprometimentos estéticos (CASTRO NETO et al, 2014). Assim, a busca por melhores resultado estético, por redução do desconforto pós-operatório observados nas grandes toracotomias, por rápida recuperação pós-operatória, além da redução de complicações em comparação à cirurgia convencional são os maiores objetivos da técnica minimamente invasiva, a qual tem se mostrado segura e eficaz (FORTUNATO JUNIOR et al, 2012). Fatos esses que foram decisivos para a escolha da técnica utilizada no paciente relatado no caso.…”

Section: Discussionunclassified

Relato de caso: métodos terapêuticos e avaliação prognóstica na doença coronariana multiarterial

Neto¹,

Guimarães²,

Montella³

et al. 2022

BJDV

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As doenças cardiovasculares são as principais causas de morte por doença no Brasil. A doença coronariana crônica (DAC) é o resultado da formação de placas de aterosclerose compostas por tecido fibroso e colesterol. Tipicamente na circulação coronariana, quando a oclusão crônica atinge 70%, o fluxo está comprometido e a demanda excede a oferta. A DAC caracteriza-se pela insuficiência de irrigação sanguínea no coração por meio das artérias coronárias. Dado o exposto, este trabalho tem por objetivo relatar um caso de doença arterial coronariana multiarterial, suas abordagens terapêuticas, cirúrgicas e medicamentosas, bem como seus resultados prognósticos. Paciente de 57 anos, sexo masculino, pardo, com coronariografia demostrando lesão ulcerada de 60% em terço distal do tronco de coronária esquerda; lesão de 90% na origem do segundo ramo diagonal de fino calibre; e lesão de 70% em terço proximal do primeiro ramo marginal esquerdo de fino calibre; sendo diagnosticado uma coronariopatia obstrutiva multiarterial. Hábitos de vida: tabagista crônico e etilista. Equipe médica avaliou o caso e determinou intervenção cirúrgica, sendo realizadas duas revascularizações do miocárdio. A abordagem cirúrgica utilizada foi a técnica minimamente invasiva, realizando uma toracotomia anterior esquerda no quarto espaço intercostal de aproximadamente 6 centímetros. O procedimento cirúrgico não apresentou intercorrências, e o paciente recebeu alta hospitalar no quinto dia pós-operatório, e retornou após 5 dias, não sendo detectadas nenhuma intercorrência. Estatisticamente a cirurgia de revascularização do Miocárdio (CRM) foi superior à Terapia Medicamentosa (TM) e à Intervenção Coronariana Percutânea (ICP) para os desfechos combinados de Infarto Agudo do Miocárdio (IAM), revascularização adicional e mortalidade. Portanto é deferível que pacientes cirúrgicos possuem melhor prognóstico. Destarte, a conduta e procedimentos realizados pela equipe foram adequados e recomendados de acordo com a literatura.

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Section: Discussionunclassified

Relato de caso: métodos terapêuticos e avaliação prognóstica na doença coronariana multiarterial

Neto¹,

Guimarães²,

Montella³

et al. 2022

BJDV

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“…Among the major experiments, Poffo et al [10] reported a case series of 102 patients who underwent surgery between 2006 and 2008, and more recently. Junior Fortunato et al [12] reported the results of 136 patients who underwent surgery over 6 years.…”

Section: Discussionmentioning

confidence: 99%

“…Data from the Society of Thoracic Surgery (STS) show that less than 20% of valve surgeries are performed by minimally invasive incisions, and there are few centers that make these surgeries more routine [1,2,9]. In our country, that number should be even lower, given the small number of publications on minimally invasive valve surgery, and with relatively small case series [10][11][12][13]. Among the major experiments, Poffo et al [10] reported a case series of 102 patients who underwent surgery between 2006 and 2008, and more recently.…”

Section: Discussionmentioning

confidence: 99%

Initial experience with minimally invasive cardiac operations

Costa

Winter

Ferreira

et al. 2012

Revista Brasileira De Cirurgia Cardiovascular

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Background: Minimally invasive cardiovascular operations have been proposed as an alternative method to correct several cardiac congenital and acquired heart diseases, with the aim to reduce morbidity and mortality.Objectives: Describe the two years initial experience with minimally invasive operations, with emphasis on technical aspects and the learning curve.Methods: Between July 2009 and March 2012, 95 patients were operated using minimally invasive operations. Mean age was 55 ± 15 years and 53% were females. The operations performed were atrial septal defect closure (25), aortic valve replacement (32), mitral valve repair (23), mitral valve replacement (12), excision of atrial myxoma (2) and resection of subaortic membrane (1). The incision was a mini right thoracotomy in 87 cases and ministernotomy in 8.Results: Early mortality was 4.2%. Mean size of the incision was 6.3 ±1.2 cm. Extension of the original thoracotomy was necessary in only one case. Two patients suffered a stroke, and the mean total blood loss was 470 ± 277 ml. There were no cases of incision infection and 67% the patients had no major morbidity. Conclusions

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A clinical study of thoracoscopy-assisted mitral valve replacement concomitant with tricuspid valvuloplasty, with domestically manufactured pipeline products for cardiopulmonary bypass

Cao

Chen

et al. 2014

J Cardiothorac Surg

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ObjectiveTo discuss the feasibility and experience of treating valvular heart diseases with thoracoscopy-assisted mitral valve replacement concomitant with tricuspid valvuloplasty, with domestically manufactured pipeline products for cardiopulmonary bypass.MethodsA total of 135 patients with valvular heart disease were admitted to our hospital between January 2011 and January 2013. They received thoracoscopy-assisted mitral valve replacement concomitant with tricuspid valvuloplasty, with domestically manufactured pipeline products. A cardiopulmonary bypass with domestically-manufactured pipeline products was established during the surgery. The procedure was accomplished with the assistance of thoracoscopy through a small incision in the right chest wall.ResultsAll 135 patients underwent a successful surgery, and were followed up for the duration of half a year to two years. None of them displayed any evidence of complications. Our procedure had the advantage of fewer complications and a significantly shortened time period for the patient care and hospitalization. As opposed to imported pipeline products for cardiopulmonary bypass, our procedure had the advantage of similar clinical results at a lower cost.ConclusionsThoracoscopy-assisted mitral valve replacement concomitant with tricuspid valvuloplasty was proved to be a safe and effective method for cardiopulmonary bypass, with the use of domestically manufactured pipeline products.Electronic supplementary materialThe online version of this article (doi:10.1186/s13019-014-0160-2) contains supplementary material, which is available to authorized users.

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Cirurgia cardíaca videoassistida

Cited by 4 publications

References 40 publications

Relato de caso: métodos terapêuticos e avaliação prognóstica na doença coronariana multiarterial

Relato de caso: métodos terapêuticos e avaliação prognóstica na doença coronariana multiarterial

Initial experience with minimally invasive cardiac operations

A clinical study of thoracoscopy-assisted mitral valve replacement concomitant with tricuspid valvuloplasty, with domestically manufactured pipeline products for cardiopulmonary bypass

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