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Facile minimally invasive cardiac surgery via ministernotomy
S R Gundry1, O H Shattuck, A J Razzouk
1Department of Surgery, Loma Linda University Medical Center, California 92354, USA.
The Annals of Thoracic Surgery
|May 16, 1998
Summary
Minimally invasive cardiac surgery using ministernotomy offers benefits by limiting trauma. This technique was successfully applied to 82 patients, including infants and adults, for various heart procedures.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Surgery
Background:
- Public and surgeon perceptions of minimally invasive surgery often differ.
- Minimally invasive approaches may offer benefits by reducing skin and skeletal trauma.
Purpose of the Study:
- To evaluate the feasibility and outcomes of a ministernotomy approach for a wide range of adult and pediatric cardiac procedures.
Main Methods:
- A ministernotomy technique was employed for infant, pediatric, and adult open-heart procedures starting in 1996.
- Incisions ranged from 1-3 inches for pediatric cases and 2.5-3.5 inches for adult valve replacements.
- The approach was adapted for various congenital and acquired heart conditions, including valve replacements and complex reconstructions.
Main Results:
- Eighty-two patients (57 pediatric, 25 adult) underwent surgery with ages ranging from newborn to 81 years.
- Procedures included aortic valvotomy, arterial switch, septal defect closures, valve replacements/repairs, and aortic root/arch reconstruction.
- Hospital stays were short (median 2 days), with most patients extubated immediately. Patient and family acceptance was high.
Conclusions:
- Ministernotomy is a viable approach for a broad spectrum of congenital cardiac and isolated adult valve operations.
- The technique allows for the elimination of femoral cannulation and does not require specialized instruments.