title: Surgical, anesthetic, perfusion-related advances in minimal access surgery.
abstract: As we enter the fifth decade in cardiac surgery, traditionally cardiac surgery has been performed using a median sternotomy with cardiopulmonary bypass providing great access to the heart and all the surrounding structures. During the last decade, there has been a paradigm shift in the methods by which surgery has been performed. The invasiveness of many procedures has been dramatically reduced, with significantly superior outcomes, as evidenced by improved survival, fewer complications, and quicker return to functional health and productive life. This resulted in significant interest and excitement in adopting less invasive techniques in cardiac surgery. Unfortunately, this was an unrealistic expectation due to the limitations that existed in cardiac surgical techniques and conventional endoscopic instruments, cardiac anesthesia, and cardiopulmonary bypass techniques. In this article, the advances in minimally invasive surgical, cardiac anesthesia, and cardiopulmonary bypass techniques in the evolution of minimal access cardiac surgery are summarized.
authors.affiliation: Department of Surgery, University of Weatern Ontario, Longon Health Science Center, University Campus, Ivey Cardiac Centre, London, Ontario, Canada. bob.kiaii@lhsc.on.ca
authors.forename: Bob
authors.initials: B
authors.lastname: Kiaii
authors.forename: Daniel
authors.initials: D
authors.lastname: Bainbridge
authors.forename: Philip
authors.initials: P
authors.lastname: Fernandes
mesh_terms: D000758:Anesthesia / Q000379:methods*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002315:Cardiopulmonary Bypass / Q000379:methods; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D018579:Patient Selection; D012371:Robotics / Q000379:methods; D017216:Telemedicine / Q000379:methods