Minimally Invasive Cardiac Surgery in China: Multi-Center Experience

Abstract

BackgroundTo the best of our knowledge, there is no nationwide data available on the development of minimally invasive cardiac surgery (MICS) in China. The purpose of this study was to report the results of MICS in 6 experienced centers in China.Material/MethodsFrom September 2014 to July 2016, 1241 patients with cardiac conditions who underwent MICS procedures were randomly enrolled in 6 centers in China, and those patients were randomly selected for inclusion in this study. The MICS procedures were defined as any cardiac surgery performed through a less invasive incision, rather than a complete median sternotomy, mainly including mini-incision surgery (400, 32.2%), video-assisted approach (265, 21.3%), completely thoracoscopic approach without robotic assistance (504, 40.6%), and robotic procedure (55, 4.4%).ResultsThe 5 most common in-hospital complications were respiratory failure (28, 2.3%), reoperation for all reasons (19, 1.5%), renal failure (11, 0.9%), heart failure (9, 0.7%), and stroke (6, 0.5%). The multivariate logistic regression analysis results showed that cardiopulmonary bypass (CPB) time (P=0.033), aortic cross-clamp time (P=0.003), cannulation approach (P=0.010), and left ventricular ejection fraction (LVEF) (P=0.003) at baseline were all significant risk factors of any in-hospital complication of MICS procedures.ConclusionsFrom our experience, minimally invasive cardiac approaches are safe and reproducible, with acceptable CPB and aortic cross-clamp time duration and low mortality.

Demographic and Surgical Profile of the Patients Underwent Minimally Invasive Cardiac Surgery in a Rural Center of Bangladesh

“…In the study of Hua mean age was 47.9±16.8 years, more than 70 years, 78(6.3%) and more than 80 years, 3 cases. 10 In the study of Iribarne , mean age was 57.2±15.1 years, more than 70 years 214 cases and 48 cases who were more than 80 years. 7 In case of Costa mean age was 55±15 years and in the study done by Barbero, mean age was 62.5 8,9 Regarding surgical approaches, we opted right anterolateral thoracotomy in maximum 27(67.50%) cases and left anterolateral thoracotomy in 10 cases (25.00%).…”

“…Length of stay in the ICU ranged from 12 hours to 13 days(mean 2.8±1.7day) and length of hospital stay was 4-30 days( mean 8.7±4.5day) in a study of Costa 8. But it was 99.1±36.3 hours and 25±5.5 days in a study done by Hua 10. During our study we found shortage of MICS instruments and latest technical knowhow are the drawbacks of further progress of MICS in our institute.During MICS, it was seen that it is safe with an excellent post operative outcome.…”

Application and effects of an early childhood education machine on analgesia and sedation in children after cardiothoracic surgery

“…Congenital heart disease and congenital diseases of the lungs, esophagus, and mediastinum are common conditions in children that need cardiothoracic surgery. In recent years, minimally invasive surgery, percutaneous device technology, and video-assisted thoracoscopy have been rapidly developed and widely used in cardiothoracic surgery, and most patients can receive these treatments [ 13 , 14 ]. However, some patients still need traditional median and transthoracic incisions.…”

Simultaneous lung and cardiac surgery: first case of a totally robotic approach

“…There is increased interest in pursuing a robotic approach as early experience indicates some potential advantages (4). On the other hand, robotic cardiac surgery arises from an interest in reducing patient trauma by using a small incision with videothoracoscopic assistance (5). Currently, the da Vinci surgical system is the only device approved for cardiac surgery.…”