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3D Thoracoscopic Cardiac Surgery: A Analysis of 160 Cases
Huiming Guo, Jian Liu, Bin Xie, Xiaosheng Zhang, Xin Zang, Wenda Gu, Bo Chen, Jian Zhuang.
Guangdong General Hospital, Guangzhou, China.

OBJECTIVE: The aim of this study was to evaluate the efficacy and safety of cardiac surgery assisted by 3-Dimensional thoracoscopy.
METHODS: Retrospective analysis was made in 160 cardiac surgery cases (male 76 cases,48%; female 84 cases, 52%) assisted by 3D thoracoscopy from March 2014 to May 2015. The mean age was 48.3±14.95 years (Range: 15 to 79 years). Among the total 160cases, there were 56 MVR (concomitant TVP:16 cases), 7 TVR cases, MVP was performed in 36 cases (concomitant TVP: 9 cases, 3 cases were transited to MVR due to repair failure), left atrial myxoma resection 12 cases, surgical ablation for atrial fibrillation in 2 cases, 23 MID-CAB cases used 3D thoracoscopy to harvest the LIMA, meanwhile, congenital cardiac surgeries included 20 ASD repair, 1 VSD repair, 1 Cor Triatriatum correction, 1 Unroofed Coronary Sinus Syndrome correction and 1 PAVC repair. Eleven cases had received cardiac surgery before. All cases were performed using 30° 3D thoracoscopy, 3D HD display screen. CPB was established via femoral artery, femoral vein and internal jugular vein.
RESULTS: Two Re-TVR patients died, in hospital mortality was 1.3%.Two cases were transited to median sternotomy due to severe pericardium adhesion and LIMA injury. Total mechanical ventilation time was 16.1±25.4(Range, 2-227) hours, hospital stay after surgery was 6.9±7.9 (Range, 1-36) days, ICU stay was 50.4±78.2 (Range, 12-777) hours. Chest drainage volume in first 24 hours was 170.7±175.46 ml. Other complications included re-operation for bleeding (5 cases, 3.1%), pneumonia (12 cases, 7.5%), poor wound healing (6 cases, 3.7%), pneumothorax (3 cases, 1.8%), hypoxemia(1 case, 0.6%), stroke(1 case, 0.6%).
CONCLUSIONS: 3D thoracoscopy could be used in various cardiac surgeries safely. It can also be used in high risk re-operation patients under critical assessment.


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