[Thoracoscopic cardiac surgical procedures: a report of 674 cases].
OBJECTIVE
To evaluate the efficacy and safety of thoracoscopic cardiac surgical procedures under extracorporeal circulation.


METHODS
From May 2000 to May 2006, 674 patients received thoracoscopic cardiac surgery under extracorporeal circulation. These procedures included atrial septal defect occlusion for 238 patients, ventricular septal defect occlusion for 380 patients and mitral valve replacement for 56 patients. Thirty degree thoracoscopes and femoral extracorporeal circulation were used. The aorta was cross-clamped and the myocardium was protected by coronary perfusion with cold crystal or blood cardioplegia.


RESULTS
The operation succeed in 645 patients (96%, 645/674). Enlarging the incision was performed in 28 patients. Operation time was from 1.8 h to 5.6 h with the mean of (2.8 +/- 1.2) h. Cardiopulmonary bypass time was from 56 min to 198 min with the mean of (78 +/- 2.3) min. Aortic cross-clamp time was from 8 min to 96 min with the mean of (31 +/- 19) min. The volume of chest drainage was (140 +/- 46) ml. None but one postoperative death occurred, the mortality was 0.15%. Postoperative complications occurred in 48 cases (7%), including bleeding in 8 patients, leakage in 5 patients (reoperation in 2 patients) and hemo-pneumothorax in 33 patients. One patient died postoperatively from cerebral hemorrhage (0.15%, 1/647).


CONCLUSIONS
Thoracoscopic cardiac surgical procedures for atrial septal defect occlusion, ventricular septal defect occlusion and mitral valve replacement is feasible and safe.
Cheng
Yun-ge
YG
Department of Cardiovascular Surgery, No.3 People's Hospital Affiliated to Shanghai Jiao Tong University School of Medcine, Shanghai 201900, China. chengyunge@126.com
Wang
Yue-jun
YJ
Zhang
Quan
Q
Gu
Jian-min
JM
Ni
Da
D
D000293:Adolescent; D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005112:Extracorporeal Circulation; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000601:surgery; D006345:Heart Septal Defects, Ventricular / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D008943:Mitral Valve / Q000601:surgery; D012189:Retrospective Studies; D013906:Thoracoscopy; D016896:Treatment Outcome