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Combine Cardiac Surgery: Minimally Invasive Incisions, Multiple Operations. A Case Series
Jing Li, Xinglong Zheng, Yuying Cheng, Yang Yan;
The First Affiliated Hospital of Xi’an Jiaotong, Xi'an, China
We have embraced a minimally invasive small thoracotomy approach in our department. Encouraged by its favorable outcomes, this method has been evolved beyond its initial confines, extending its application to encompass more intricate cardiac procedures, beyond isolated mitral valve replacement (MVR) or aortic valve replacement (AVR). We performed complex minimally invasive composite cardiac surgery on nine patients in this case series:1.Minimally invasive valve surgery with coronary artery bypass (6 cases)a. Bilateral mini-thoracotomy for combined minimally invasive direct coronary artery bypass and mitral valve repair or replacement (4 cases);b. Bilateral mini-thoracotomy for combined minimally invasive direct coronary artery bypass and aortic valve replacement (1 case); c. Bilateral mini-thoracotomy for combined minimally invasive direct coronary artery bypass and Triple valve surgery (1 case, Figure); 2.Mini-Bentall with minimally invasive direct coronary artery bypass (2 cases); 3.Repaired of congenital atrial septal defect combined with coronary-pulmonary artery leakage (2 cases). Herein, we detailly described three different types of combined cardiac surgical approaches and statistically analyzed operative times (including cardiopulmonary bypass and aortic cross-clamp times). Meanwhile, we assessed postoperative outcomes (including postoperative atrial fibrillation; TIA/stroke; surgical recurrence; Septicemia; and mortality), highlighting the feasibility and utility of such minimally invasive combined procedures. The research results indicate that our composite minimally invasive surgery demonstrates remarkable stability. This is evident from our surgical duration, the overwhelmingly positive patient recoveries, the swift weaning off mechanical ventilation, the efficiency in transferring patients out of intensive care settings, and the infrequent occurrence of postoperative complications.
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