title: Video-assisted cardiac surgery: results from a pioneer project in Brazil.
abstract: OBJECTIVE
  To demonstrate the possibilities of the use of videothoracoscopy in cardiac surgery using cardiopulmonary bypass (CPB).
  
  
  METHODS
  Between February 2006 and November 2008, 102 patients underwent consecutively minimally invasive video-assisted cardiac surgery. The cardiac pathologies approached were: mitral valvopathy (n=56), aortic (n=14), interatrial communication (IC) (n=32), six patients presented associated tricuspid insufficiency and 12 presented atrial fibrillation. The age ranged from 18 to 68 years and 57 were female. The surgical approach was: femoral arterial and venous cannulation, minithoracotomy ranging from four to six centimeters (cm) at the level of the 3 degrees or 4 degrees right intercostal space (RICS), depending on the pathology of the patient, between anterior axillary line and hemiclavicular line, submammary or right periareolar groove through the right breast and thoracoscopy.
  
  
  RESULTS
  The surgical procedures were: plasty (n=20) or mitral valve replacement (n=36), aortic valve replacement (n=14), atrioseptoplasty using pericardial patch (n=32), tricuspid valve repair with rigid ring (n=6) and surgical correction of atrial fibrillation with radiofrequency (n=12). There were no complications during the procedures. There was no conversion to thoracotomy in neither case. Two patients developed atrial fibrillation in the postoperative period. There was an episode of stroke seven days after the hospital discharge and one death (0.9%) due to systemic inflammatory response syndrome (SIRS).
  
  
  CONCLUSIONS
  This study demonstrates the coverage of pathologies that are possible to be approached by video-assisted cardiac surgery with cardiopulmonary bypass being a safe and effective procedure with low morbimortality. Minimally invasive video-assisted cardiac surgery is already a reality in Brazil, demonstrating excellent aesthetic and functional results.
authors.affiliation: Surgical Clinics at Federal University of Paraná, Brazil. drpoffo@einstein.br
authors.forename: Robinson
authors.initials: R
authors.lastname: Poffo
authors.forename: Renato Bastos
authors.initials: RB
authors.lastname: Pope
authors.forename: Rafael Armínio
authors.initials: RA
authors.lastname: Selbach
authors.forename: Cláudio Alexandre
authors.initials: CA
authors.lastname: Mokross
authors.forename: Fabiane
authors.initials: F
authors.lastname: Fukuti
authors.forename: Iosmar da
authors.initials: Id
authors.lastname: Silva Júnior
authors.forename: Andréia
authors.initials: A
authors.lastname: Agapito
authors.forename: Isaias
authors.initials: I
authors.lastname: Cidral
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil; D002315:Cardiopulmonary Bypass / Q000379:methods; D005260:Female; D006331:Heart Diseases / Q000145:classification / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects / Q000379:methods*; D055815:Young Adult