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Minimal Invasive Surgical Procedure of Inducing Myocardial Infarction in Mice
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Minimally invasive approach for complex cardiac surgery procedures.

Pasquale Totaro1, Simone Carlini, Matteo Pozzi

  • 1Division of Cardiac Surgery, Istituto Di Ricovero e Cura a Carattere Scientifico University Hospital Foundation San Matteo, Pavia, Italy. ptotaro@yahoo.com

The Annals of Thoracic Surgery
|July 28, 2009
PubMed
Summary

Upper ministernotomy (UMS) is a safe and feasible minimally invasive approach for various cardiac surgeries, including complex procedures. This technique offers favorable outcomes comparable to traditional methods, even for redo operations.

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Area of Science:

  • Cardiovascular Surgery
  • Minimally Invasive Cardiac Surgery

Background:

  • Upper ministernotomy (UMS) has been utilized since 1997 for cardiac procedures.
  • This approach has evolved from isolated aortic valve replacement (AVR) to more complex surgeries.
  • UMS is now the preferred method for various cardiac operations in the division.

Purpose of the Study:

  • To evaluate the 11-year experience with the upper ministernotomy (UMS) approach.
  • To assess the feasibility and safety of UMS for isolated AVR, redo AVR, and complex cardiac procedures.
  • To compare early postoperative outcomes across different surgical procedure types using UMS.

Main Methods:

  • A retrospective analysis of 1,126 cardiac procedures performed between 1997 and 2007 using UMS.
  • Procedures were categorized into isolated AVR (695 patients), redo AVR (77 patients), and complex procedures (354 patients).
  • Early postoperative outcomes including conversion to full sternotomy, in-hospital mortality, prolonged mechanical ventilation, ICU stay, and surgical revision rates were analyzed.

Main Results:

  • Overall conversion to full sternotomy was low (1.4%) with no significant difference between procedure types.
  • Cumulative in-hospital mortality was 4.1%, with significantly higher mortality observed only in complex procedures (6.7%).
  • Outcomes like prolonged ventilation and ICU stay were significantly different only for complex procedures; surgical revision rates were similar across all groups.

Conclusions:

  • Upper ministernotomy (UMS) is a safe and feasible minimally invasive option for isolated AVR and complex cardiac surgeries.
  • The UMS approach can be beneficial for complex and redo procedures without compromising surgical results.
  • Minimizing surgical access via UMS may offer advantages for patients undergoing intricate cardiac operations.