[Minimally invasive surgery with the Port-Access method. Preliminary experience]

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Cardiac Surgery
• Thoracic Surgery

Background:

• The Port-Access technique represents a novel minimally invasive surgical approach.
• It aims to combine the benefits of minimally invasive surgery with the capabilities of cardiopulmonary bypass.
• This technique addresses limitations of classic minimally invasive direct coronary artery bypass (MIDCAB).

Purpose of the Study:

• To report the initial experience with the Port-Access technique in cardiac surgery.
• To evaluate the feasibility and outcomes of this minimally invasive approach for mitral valve disease and coronary stenosis.
• To assess the safety and efficacy of Port-Access surgery in a diverse patient cohort.

Main Methods:

• The study involved 40 patients undergoing cardiac surgery using the Port-Access technique.
• Procedures included mitral valvuloplasty, valve replacement, and various configurations of coronary artery bypass grafting (CABG).
• The technique utilizes cardiopulmonary bypass with femoral access, endoaortic clamping, and specialized catheter systems for myocardial preservation.

Main Results:

• No operative deaths were recorded among the 40 patients.
• The mean postoperative hospital stay was 5.5 days.
• Complications occurred in 7 patients, including bleeding requiring revision and one case requiring conversion to median sternotomy, potentially related to the learning curve.

Conclusions:

• Port-Access surgery is a viable minimally invasive option for complex cardiac procedures.
• It offers aesthetic and functional advantages while accommodating a wide range of surgical interventions.
• Contraindications include iliac-femoral disease and severe ascending aorta dilatation.