Minimal access heart surgery via lower ministernotomy: experience in 460 cases.
Minimally invasive cardiac surgery has captured the interest and attention of cardiac surgeons throughout the world. We reviewed our experience of minimal access cardiac operations performed through a lower median ministernotomy. Between January 1997 and August 2003, 100 congenital, 178 valvular, 168 coronary, 12 aneurysmal, and 2 other operations were performed via a 6 to 9 cm lower ministernotomy in 460 consecutive patients. No special instruments were required. Four patients died, and 2 re-operations were necessary. Complications occurred in 28 patients (6.1%). The mean cardiopulmonary bypass time was 88.50 +/- 65.16 min, crossclamp time was 55.81 +/- 31.89 min, time to extubation was 14.71 +/- 29.33 h, and total chest drainage was 7.28 +/- 5.07 mL.kg(-1). Blood transfusions of 951.42 +/- 642.34 mL were needed in 282 patients. Postoperative hospital stay was 11.6 +/- 6.0 days. Our experience shows that many types of cardiac operations can be performed through a lower ministernotomy. This technique results in less trauma, quick recovery, and reduces the risk of infection and blood loss. It is a safe and easy procedure that can bring about favorable early outcomes in a wide range of cardiac operations.
Department of Cardiovascular Surgery, Fu Wai Hospital, 167 Northern Lishi Road, Beijing 100037, China. shs1505@sina.com
Han-Song
HS
Sun
Wei-Guo
WG
Ma
Jian-Ping
JP
Xu
Li-Zhong
LZ
Sun
Feng
F
Lu
Xiao-Dong
XD
Zhu
D000293:Adolescent; D000328:Adult; D000368:Aged; D002681:China; D015331:Cohort Studies; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D012086:Reoperation; D012189:Retrospective Studies; D013908:Thoracotomy / Q000379:methods*; D016896:Treatment Outcome