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Our Initial Experience of Minimally Invasive Cardiac Surgical Procedures Via Right Mini-Thoracotomy

Year 2018, Volume: 21 Issue: 2, 157 - 162, 19.08.2018

Abstract

Introduction: The aim of
this study is to present the results of patients undergoing atrial septal
defect (ASD) repair and mitral valve replacement (MVR) via right
mini-thoracotomy and to share the initial experience of minimally invasive
cardiac surgical procedures.



Patients and Methods:
Preoperative,
intraoperative, and postoperative data of patients undergoing ASD repair and
MVR via right mini-thoracotomy between November 2016 and November 2017 were
retrospectively reviewed.



Results: During
the study period, 22 patients were planned right mini-thoracotomy. The mean age
of the patients was 30.4 ± 10.6 years (range, 18-73). Over 22, 3 patients
underwent unplanned median sternotomy. Of the remaining 19 patients, 14
patients underwent ASD repair and 5 patients underwent MVR; all successfully
via right mini-thoracotomy.



Conclusion: Minimally invasive
procedures are characterized by low postoperative complication rate, short
intensive care time, early recovery period and high patient comfort. These
procedures can be safely performed by operators who are in the initial stages
of their minimal invasive surgery learning curve.

References

  • 1. Gammie JS, Zhao Y, Peterson ED, O’Brien SM, Scott R, Griffith BP. Less-invasive mitral valve operations: trends and outcomes from the society of thoracic surgeons adult cardiac database. Ann Thorac Surg 2010;90:1401-10.
  • 2. Sündermann SH, Sromicki J, Rodriguez Cetina Biefer H, Seifert B, Holubec T, Falk V, et al. Mitral valve surgery: right lateral minithoracotomy or sternotomy?A systematic review and meta-analysis. J Thorac Cardiovasc Surg 2014;148:1989-95.
  • 3. Ding C, Wang C, Dong A, Kong M, Jiang D, Tao K, et al. Anterolateral minithoracotomy versus median sternotomy forthe treatment of congenital heart defects: a meta-analysis and systematic review. J Cardiothorac Surg. 2012;4;7:43.
  • 4. Falk V, Cheng DC, Martin J, Diegeler A, Folliguet TA, Nifong LW, et al. Minimalinvasive versus open mitral valve surgery:a consensus statement of the international society of minimally invasive coronary surgery (ISMICS) 2010. Innovations (Phila) 2011;6:66-76.
  • 5. Murzi M, Cerillo AG, Bevilacqua S, Gasbarri T, Kallushi E, Farneti P, et al. Enhancing departmental quality control in minimally invasive mitral valve surgery: a single-institution experience. Eur J Cardiothorac Surg 2012; 42:500-6.
  • 6. Holzhey DM, Seeburger J, Misfeld M, Borger MA, Mohr FW. Learning minimally invasive mitral valve surgery. A cumulative sum sequential probability analysis of 3895 operations from a single high-volume center. Circulation 2013;128:483-91.
  • 7. Ito T. Minimally invasive mitral valve surgery through right mini-thoracotomy: recommendations for good exposure, stable cardiopulmonary bypass, and secure myocardial protection. Gen Thorac Cardiovasc Surg 2015;63:371-8.
  • 8. Ward AF, Grossi EA, Galloway AC. Minimally invasive mitral surgery through right mini-thoracotomy under direct vision. J Thorac Dis 2013;5(Suppl 6):S673-9.
  • 9. Taşoğlu İ, Avcı T, Koca S, Paç A, İrdem AK, Collaku A, et al. Atrial septal defect closure via right mini-thoracotomy: Our single center experience. Turk Gogus Kalp Dama 2017;25:565-72.
  • 10. Iribarne A, Easterwood R, Yang J, Dayal R, Argenziatno M. Retroperitoneal hematoma with abdominal compartment syndrome during minimally invasive mitral valve replacement. Ann Thorac Surg 2010;89:e17-8.
  • 11. Seeburger J, Borger MA, Falk V, Kuntze T, Czesla M, Walther T, et al. Minimal invasive mitral valve repair for mitral regurgitation: results of 1339 consecutive patients. Eur J Cardiothorac Surg 2008;34:760-5.

Sağ Mini Torakotomi ile Gerçekleştirilen Minimal İnvaziv Kalp Cerrahisi Prosedürlerinde Başlangıç Tecrübelerimiz

Year 2018, Volume: 21 Issue: 2, 157 - 162, 19.08.2018

Abstract

Giriş: Bu çalışmanın amacı, sağ mini torakotomi ile atrial
septal defekt onarımı (ASD) ve mitral kapak replasmanı (MVR) yapılan hastaların
sonuçlarını sunmak; minimal invaziv kardiyak cerrahi prosedürler ile ilgili
erken dönem deneyimlerimizi paylaşmaktır.



Hastalar ve Yöntem: Kasım 2016 ila Kasım 2017 tarihleri
arasında sağ mini torakotomi ile ASD onarımı ve MVR amacıyla operasyona alınan
tüm hastalar çalışmaya dahil edildi. Hastaların preoperatif, intraoperatif ve
postoperatif verileri retrospektif olarak incelendi.



Bulgular: Çalışma sürecinde toplam 22 hastaya sağ mini torakotomi
ile girişim planlandı. Hastaların yaşları 18 ila 73 arasında olup, ortalama
30.4 ± 10.6 yıldı. Toplam 3 (%13.6) hastada önceden planlanmayan sternotomi
ihtiyacı oldu. Geri kalan 14 hastaya ASD onarımı, 5 hastaya MVR yapıldı.



Sonuç: Minimal invaziv
prosedürler düşük postoperatif komplikasyon oranı, kısa yoğun bakım süresi,
erken taburculuk oranları ile  yüksek
hasta konforu sağlamaktadırlar. Bununla birlikte uzun kardiyopulmoner baypas ve
kross klemp süreleri işlemin devantajı olarak değerlendirilmiştir. Bu
operasyonlar başlangıç aşamasında olan operatörler  tarafından güvenle uygulanabilmektedirler.

References

  • 1. Gammie JS, Zhao Y, Peterson ED, O’Brien SM, Scott R, Griffith BP. Less-invasive mitral valve operations: trends and outcomes from the society of thoracic surgeons adult cardiac database. Ann Thorac Surg 2010;90:1401-10.
  • 2. Sündermann SH, Sromicki J, Rodriguez Cetina Biefer H, Seifert B, Holubec T, Falk V, et al. Mitral valve surgery: right lateral minithoracotomy or sternotomy?A systematic review and meta-analysis. J Thorac Cardiovasc Surg 2014;148:1989-95.
  • 3. Ding C, Wang C, Dong A, Kong M, Jiang D, Tao K, et al. Anterolateral minithoracotomy versus median sternotomy forthe treatment of congenital heart defects: a meta-analysis and systematic review. J Cardiothorac Surg. 2012;4;7:43.
  • 4. Falk V, Cheng DC, Martin J, Diegeler A, Folliguet TA, Nifong LW, et al. Minimalinvasive versus open mitral valve surgery:a consensus statement of the international society of minimally invasive coronary surgery (ISMICS) 2010. Innovations (Phila) 2011;6:66-76.
  • 5. Murzi M, Cerillo AG, Bevilacqua S, Gasbarri T, Kallushi E, Farneti P, et al. Enhancing departmental quality control in minimally invasive mitral valve surgery: a single-institution experience. Eur J Cardiothorac Surg 2012; 42:500-6.
  • 6. Holzhey DM, Seeburger J, Misfeld M, Borger MA, Mohr FW. Learning minimally invasive mitral valve surgery. A cumulative sum sequential probability analysis of 3895 operations from a single high-volume center. Circulation 2013;128:483-91.
  • 7. Ito T. Minimally invasive mitral valve surgery through right mini-thoracotomy: recommendations for good exposure, stable cardiopulmonary bypass, and secure myocardial protection. Gen Thorac Cardiovasc Surg 2015;63:371-8.
  • 8. Ward AF, Grossi EA, Galloway AC. Minimally invasive mitral surgery through right mini-thoracotomy under direct vision. J Thorac Dis 2013;5(Suppl 6):S673-9.
  • 9. Taşoğlu İ, Avcı T, Koca S, Paç A, İrdem AK, Collaku A, et al. Atrial septal defect closure via right mini-thoracotomy: Our single center experience. Turk Gogus Kalp Dama 2017;25:565-72.
  • 10. Iribarne A, Easterwood R, Yang J, Dayal R, Argenziatno M. Retroperitoneal hematoma with abdominal compartment syndrome during minimally invasive mitral valve replacement. Ann Thorac Surg 2010;89:e17-8.
  • 11. Seeburger J, Borger MA, Falk V, Kuntze T, Czesla M, Walther T, et al. Minimal invasive mitral valve repair for mitral regurgitation: results of 1339 consecutive patients. Eur J Cardiothorac Surg 2008;34:760-5.
There are 11 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Original Investigations
Authors

Mehmet Aksüt This is me

Tanıl Özer This is me

Özge Altaş Yerlikhan This is me

Emre Selçuk This is me

Mehmed Yanartaş This is me

Publication Date August 19, 2018
Published in Issue Year 2018 Volume: 21 Issue: 2

Cite

Vancouver Aksüt M, Özer T, Altaş Yerlikhan Ö, Selçuk E, Yanartaş M. Sağ Mini Torakotomi ile Gerçekleştirilen Minimal İnvaziv Kalp Cerrahisi Prosedürlerinde Başlangıç Tecrübelerimiz. Koşuyolu Heart Journal. 2018;21(2):157-62.