Preliminary Discussion Of Video Assisted Minimally Invasive Cardiac Surgery

Objective: To compare Video-assisted thoracic surgery Repair of atrial septal and replacement of mitral valve with Median open surgery,Evaluate the safety of the thoracoscopic surgery,as well as the cosmetic effect of thoracoscopic surgery scientifically.Methods: Atrial septal defect repair(ASD)group: From May 2011 to January 2016,A total of 38 patients with ASD were included.patients pass through either right chest port-access totally video-assisted thoracoscopic surgery(TS)(thoracoscopic group,n = 18)or conventional median sternotomy(conventional group,n = 20).The time of cardiopulmonary bypass,cross-clamp ascending aorta,ventilator assisted time,volume of postoperative chest drainage,postoperative hospital stay and Six months after review of the situation were compared between the two groups.Mitral valve replacement(MVR)group: From May 2011 to January 2016,A total of 27 patients mitral valve disease were included,patients with either right chest port-access totally video-assisted thoracoscopic surgery(thoracoscopic group,n = 12)or conventional median sternotomy(conventional group,n = 15).postoperative hospital stay,Length of incision,volume of postoperative chest drainage,cross-clamp of ascending aorta time,operation time,cardiopulmonary bypass time,Ventilator assisted time,and Six months after situation were compared between the two group.Results: The ASD repair with TS group,the volume of 24 hours chest drainage was 129 ±56ml,incision length was 5.3±1.1cm,and the operation time was 194±42min.The postoperative hospital stay was 7.3±1.9d,the ICU stay time was 5.2± 2.3h,the time of cardiopulmonary bypass was 66±26min,and the aorta occlusion time was 44±19min.In patients with open chest septum repair,the 24 hours chest drainage was 278±68ml.The incision length was 21.9±1.9cm,and the operation time was 148±27min.The postoperative hospital stay was 9.7±2.3d,the ICU stay time was 8.2±3.2h.The time of cardiopulmonary bypass was 49±14min,and the aorta occlusion time was 29±14min.In MVR patients with TS,the volume of 24 hours chest drainage was 147 ±58ml,the incision length was 5.1±0.9cm,and the operation time was 316±62min.The postoperative hospital stay was 10.9±3.9d,ICU stay time was 10.2± 3.7h,cardiopulmonary bypass time was 108±30min,and the aorta occlusion time was 65±21min.In patients with open chest MVR.,The 24 hours after operation chest drainage was 295±93ml,The incision length was 22.5±2.2cm,and the operation time was 220±39min,postoperative hospital stay was 14.7±4.3d,ICU stay time was 10.6± 4.2h,cardiopulmonary bypass time was 73±16min,and the aorta occlusion time was 47±17min.ASD repair group: video-assisted or the median thoracotomy group did not occur in patients with death.None of the patients in the thoracic surgery group had changed into the median thoracotomy.Postoperative patients were no nervous system injury,renal failure,low cardiac output.Compare with median open chest surgery,TS group’s 24 hours of postoperative drainage volume,postoperative length of incision and postoperative respiratory assisted time were significantly reduced(P < 0.05).In the TS group,the operation time,cardiopulmonary bypass time,and the aorta occlusion time were longer.Postoperative pain significantly reduced than that of conventional group.Both groups were recovered well after surgery,discharge safely;two groups of patients were no death,no low cardiac output syndrome,central nervous system and other complications.MVR group: both groups did not occur in patients with death,one case of patients with TS were converted into the median thoracotomy.Postoperative patients were not nervous system,renal failure,low cardiac output and other complications, postoperative review of the heart color Doppler ultrasound showed,two groups of patients did not appear valve leakage.Compared with the median thoracotomy group,there was no significant statistical significance in the postoperative ventilation time(P>0.05).the operation time,cardiopulmonary bypass time,and the aorta occlusion time was longer.Postoperative pain significantly reduced than that of conventional group,both groups were recovered well after surgery,safe discharged.Two groups of patients were with no death,no low cardiac output syndrome,central nervous system and other complications.Conclusion: Video-assisted cardiac surgery shows less trauma,less bleeding,shorter hospital stay,less postoperative pain,quick recovery,and the surgery is safe and feasible,also can get quite satisfactory outcome.Video-assisted minimally invasive cardiac surgery has an important value in our clinical practice.