Minimally Invasive Cardiac Surgery Without Peripheral Cannulation: A Single Centre Experience

Kale, Suresh Babu; Ramalingam, Sandeep

doi:10.1016/j.hlc.2018.08.018

Cited by 11 publications

(10 citation statements)

References 15 publications

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“…For surgeons, this incision provides excellent exposure; however, for patients, a median sternotomy confers a poorer cosmetic outcome and the possibility of postoperative respiratory dysfunction, chronic pain, and deep sternal wound infections. 1,2 In an effort to address these complications, a variety of minimally invasive techniques were developed in adult cardiac surgery over the past 20 years. Despite these advances in adult patients, the use of minimally invasive techniques in pediatric patients continues to be limited to small case series and less complex cardiac defects.…”

Section: Introductionmentioning

confidence: 99%

Borrowing from Adult Cardiac Surgeons—Bringing Congenital Heart Surgery Up to Speed in the Minimally Invasive Era

Alsarraj

Nellis

Vekstein

et al. 2020

Innovations�(Phila)

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The majority of congenital and adult cardiac surgery is performed through a median sternotomy. For surgeons, this incision provides excellent exposure; however, for patients, a median sternotomy confers a poorer cosmetic outcome and the possibility of postoperative respiratory dysfunction, chronic pain, and deep sternal wound infections. Despite the advances in adult cardiac surgery, the use of minimally invasive techniques in pediatric patients is largely limited to small case series and less complex repairs. In this article, we review the risks, benefits, and limitations of the minimally invasive congenital cardiac approaches being performed today. The interest in these approaches continues to grow as more data supporting reduced morbidity, decreased length of stay, and faster recovery are published. In the future, as the technology and surgical familiarity improve, these alternative approaches will become more common, and may someday become the standard of care.

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Section: Introductionmentioning

confidence: 99%

Borrowing from Adult Cardiac Surgeons—Bringing Congenital Heart Surgery Up to Speed in the Minimally Invasive Era

Alsarraj

Nellis

Vekstein

et al. 2020

Innovations�(Phila)

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“…Over a 2-year period (January 2017 – December 2018), the authors report a total of 140 cases of MICS (ASD closure (53%), mitral valve repair (14%), VSD closure (9%), aortic valve replacement (10%), mitral valve replacement (6%), repair of PAPVC (9%), myxoma excision (1%), VSD closure with pulmonary valvotomy (1%)), being performed with central cannulation. Similarly, Kale and Ramalingam [ 23 ] reported 145 cases of MICS performed through October 2015 to March 2017, without peripheral cannulation. The cases operated on included those performed through right anterior thoracotomy – MIMVR, ASD closures, VSD closures and correction of TOF.…”

Section: Resultsmentioning

confidence: 99%

Analysis of the logistical, economic and minimally invasive cardiac surgical training difficulties in India

Ammannaya

Solinas

Passino

2020

Arch Med Sci Atheroscler Dis

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Significant advances have been made in minimally invasive cardiac surgery (MICS) over the past 3 decades. However, the acceptance and practice of MICS continue to remain low in the developing world owing to several challenges. This study aimed to analyse the logistical, economic and training difficulties in MICS with a special focus on the Indian scenario. A systematic review of the current literature on MICS with an emphasis on these challenges was performed. MICS has been shown to have clear cost-benefit advantage that stems from shorter ICU and hospital stay, lesser transfusion requirements and avoidance of sternal wound complications. However, only limited reports are currently available detailing the economic and training challenges for the application of MICS in the developing world, particularly India. Though several challenges exist in widening MICS practice in India, these can be overcome through a target-oriented approach.

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“…The skin incision length was acceptable for MICS, compared with the findings of previous reports. 3,21 In the aorta group, arterial and venous cannulations were performed through independent 4 to 5 mm skin incisions, while patients in the femoral group required an additional 3 to 6 cm skin incision on the groin to anastomose the graft. Independent incisions for aortic cannulas were not necessary to prevent complications due to femoral cannulation, whereas in our technique, a clear operative field for intracardiac procedures was obtained.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Efficacy of Transthoracic Cannulation into the Ascending Aorta Versus Femoral Artery Cannulation in Minimally Invasive Cardiac Surgery

Nakajima

Takazawa

Tounaga

et al. 2019

Innovations�(Phila)

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Objective To delineate the efficacy and safety of transthoracic cannulation to the ascending aorta through a right pleural cavity during minimally invasive cardiac surgery (MICS). Methods We retrospectively assessed the records of 104 patients who underwent MICS in our institution between December 2011 and December 2018. Procedures included mitral valve repair (88 patients), aortic valve replacement (8 patients), atrial septal defect closure (6 patients), and myxoma resection (2 patients). Aortic valve replacements were performed through the third intercostal space (ICS), whereas the other procedures were mainly performed through the fourth ICS. The femoral group comprised 60 patients in whom an artificial graft was anastomosed to the femoral artery and 4 who underwent cannulation into the femoral artery. The aorta group comprised 40 patients in whom transthoracic cannulation was performed through the second or third ICS, separate from the main skin incision. Results No mortality or critical complications were associated with cardiopulmonary bypass. Perfusion pressure measured at outflow of the artificial lung (224 ± 43 vs. 190 ± 42; P < 0.001) and pump pressure measured at the outflow of the pump (293 ± 50 vs. 255 ± 57; P < 0.001) were significantly higher in the femoral group than in the aorta group. The skin incision lengths were similar (56.9 ± 6.9 vs. 55.1 ± 6.0 mm; P = 0.107). Conclusions Transthoracic cannulation into the ascending aorta is reliable and can be safely performed. The possible risks associated with peripheral cannulation and retrograde perfusion can be avoided thereafter.

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Minimally Invasive Cardiac Surgery Without Peripheral Cannulation: A Single Centre Experience

Cited by 11 publications

References 15 publications

Borrowing from Adult Cardiac Surgeons—Bringing Congenital Heart Surgery Up to Speed in the Minimally Invasive Era

Borrowing from Adult Cardiac Surgeons—Bringing Congenital Heart Surgery Up to Speed in the Minimally Invasive Era

Analysis of the logistical, economic and minimally invasive cardiac surgical training difficulties in India

Comparison of the Efficacy of Transthoracic Cannulation into the Ascending Aorta Versus Femoral Artery Cannulation in Minimally Invasive Cardiac Surgery

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