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Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
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Fine tuning for totally endoscopic mitral valve surgery: ERAS applications
Serkan Ertugay1, Sedat Karaca1, Ayşen Yaprak Engin1
1Department of Cardiovascular Surgery, Ege University Faculty of Medicine, Izmir, Türkiye.
Frontiers in Cardiovascular Medicine
|October 25, 2024
Summary
Totally endoscopic mitral valve surgery combined with enhanced recovery after surgery (ERAS) protocols reduces complications and transfusion needs. This approach facilitates faster patient recovery and earlier hospital discharge.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Surgery
- Enhanced Recovery Protocols
Background:
- Minimally invasive mitral surgery aims to improve patient outcomes.
- Enhanced Recovery After Surgery (ERAS) protocols complement surgical techniques for optimized postoperative care.
- Totally endoscopic mitral valve surgery (TEMVS) offers a minimally invasive approach.
Purpose of the Study:
- To present an institutional protocol for ERAS in TEMVS patients.
- To evaluate the outcomes of ERAS protocols in conjunction with TEMVS.
Main Methods:
- 113 patients undergoing TEMVS between 2021-2023.
- TEMVS performed using peripheral cannulation and 3D endoscopic technique.
- Implementation of a comprehensive ERAS protocol including patient education, anemia management, glucose optimization, rehabilitation, anxiety/analgesia treatment, blood conservation techniques, and early postoperative care.
Main Results:
- Low complication rates: respiratory (9%), infectious (3.5%), renal (3.4%).
- Reduced transfusion requirements: 68.1% received no red blood cells, 90.2% received no fresh frozen plasma.
- Shortened recovery times: median extubation 7 hours, median ICU stay 1 day, median hospital stay 5 days.
- Single early postoperative mortality.
Conclusions:
- TEMVS minimizes surgical trauma.
- ERAS protocols significantly decrease complication and transfusion rates.
- The combined approach enables early recovery and discharge after TEMVS.
Keywords:
endoscopic surgeryenhanced recoveryminimally invasive cardiac surgerymitral valve surgerypatient blood management (PBM)More Related Videos
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