Total Arterial Mics Cabg Results
RODRIGO RIBEIRO DE SOUZA, TÉRCIO CAMPOS LEÃO NETO.
Hospital São Francisco de Assis, Goiania, Brazil.
BACKGROUND - The main goal of this study is to describe our total arterial MICS CABG technique and to evaluate it's results using hostpial indicators.
METHODS - Analysis of medical records of patients undergoing MICS CABG in the period form january 2017 to november 2018. Observational, analytical, cohort study. Only patients submitted to a left lateral minithoracotomy revascularization using 03 (three) arterial grafts were included.
RESULTS - Mean age of the operated patients was 56.02 years. From a total of 109 patients, there were 94 men and 15 women. The mean ejection fraction 58.23%, EUROSCORE II 2.87%, mean incision size 4.8 cm, mean CPB time of 88.02 min, mean aortic clamping 44.43 min, femoral-femoral cannulation in 100% of cases, preoperative hematocrit of 34.58%, postoperative hematocrit of 31.55%, drain volume the first 24 hours post-operative was 229.54 ml, extubation was performed in an average time of 5.56 hours. The patients remained in the ICU for a mean time of 36.21 hours and had hospitalization hospital for an average of 4.01 days. One of the references used to collect data from conventional surgery showed EUROSCORE II 2.19, mean ejection fraction 48.22%, men with a prevalence of 76.9%, hospitalization less than 8 days in 56% of the cases, CPB time of 62.82 min and mean length of ICU stay of 44.4 hours. STS National Database data show an average of up to 6 days of hospitalization of 52.52%, ejection fraction average 50%, mean age 63 years.
CONCLUSIONS - Considering the above, compared to the results obtained in the studies evaluated, we can observe a decrease in the length of hospital stay of 20%, reduction of CPB time of 15%, reduction of incision size by 56%. Undeniably, minimally invasive surgery has developed and become a reality of difficult challenge. The trend in the coming years is the migration of surgical teams and patients to techniques with less trauma surgical time and shorter hospital stay while maintaining operative quality and results. The study demonstrates that the adoption of minimally invasive techniques substantially improves the quality of the surgery service cariovascular disease.
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