title: Initial experience with minimally invasive cardiac operations.
abstract: BACKGROUND
  Minimally invasive cardiovascular operations have been proposed as an alternative method to correct several cardiac congenital and acquired heart diseases, with the aim to reduce morbidity and mortality.
  
  
  OBJECTIVE
  Describe the two years initial experience with minimally invasive operations, with emphasis on technical aspects and the learning curve.
  
  
  METHODS
  Between July 2009 and March 2012, 95 patients were operated using minimally invasive operations. Mean age was 55 ± 15 years and 53% were females. The operations performed were atrial septal defect closure (25), aortic valve replacement (32), mitral valve repair (23), mitral valve replacement (12), excision of atrial myxoma (2) and resection of subaortic membrane (1). The incision was a mini right thoracotomy in 87 cases and ministernotomy in 8.
  
  
  RESULTS
  Early mortality was 4.2%. Mean size of the incision was 6.3 ±1.2 cm. Extension of the original thoracotomy was necessary in only one case. Two patients suffered a stroke, and the mean total blood loss was 470 ± 277 ml. There were no cases of incision infection and 67% the patients had no major morbidity.
  
  
  CONCLUSIONS
  Our initial results with minimally invasive operations demonstrated that it was safe and with good clinical results. Patient satisfaction is quite high. After the learning phase has been transversed, minimally invasive operations may be an excellent alternative for many patients with congenital and acquired diseases.
authors.affiliation: Departamento de Medicina, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brasil. fcosta13@me.com
authors.forename: Francisco
authors.initials: F
authors.lastname: Costa
authors.forename: Guilherme
authors.initials: G
authors.lastname: Winter
authors.forename: Andrea Dumsch de Aragon
authors.initials: AD
authors.lastname: Ferreira
authors.forename: Tadeu Augusto
authors.initials: TA
authors.lastname: Fernandes
authors.forename: Claudinei
authors.initials: C
authors.lastname: Collatusso
authors.forename: Fernanda Tome
authors.initials: FT
authors.lastname: Tremel
authors.forename: Fabio Rocha
authors.initials: FR
authors.lastname: Farias
authors.forename: Daniele de Fátima
authors.initials: Dde F
authors.lastname: Fornazari
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D059032:Learning Curve; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011184:Postoperative Period; D015203:Reproducibility of Results; D017678:Sex Distribution; D056346:Sternotomy / Q000379:methods*; D013908:Thoracotomy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult