Original articleAdult cardiacSteps Forward in Minimally Invasive Cardiac Surgery: 10-Year Experience
Section snippets
Material and Methods
From November 2005 to November 2015, 988 consecutive patients with diagnosis of severe mitral valve (MV) disease, severe tricuspid valve disease, and/or atrial septal defect or atrial masses were enrolled for MICS at our department. Immediate intraoperative conversion to median sternotomy was required in 17 of 988 patients (1.7%) (Figure 1). Causes of conversion were related to extensive lung adhesions in 14 cases and to peripheral vascular complications before cardiopulmonary bypass onset in 3
Results
During the study period 971 patients underwent MICS at our department. Over the same period 384 patients with comparable diagnoses underwent surgery through standard median sternotomy (Figure 1).
Figure 2 shows the trend of the procedures performed through the minimally invasive and the standard sternotomy approaches over the 10-year study period. Procedures increased from 44% (68/153) in 2006 to 95% (128/135) in 2015 for the MICS group and from 56% (85/153) in 2006 to 5% (7/135) in 2015 for the
Comment
Over the last 20 years MICS has rapidly evolved because of the development of strategies involving arterial and venous cannulation, aortic clamping, and myocardial preservation.1, 2 Several settings have been described and have become routine in the surgical practice of centers all over the world; however, there is still debate in the literature regarding their role on the occurrence of major neurologic and vascular complications.3, 4, 11
This study analyzes the evolution of our 10-year
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