Division of Cardiac Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA.
Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Innovations (Phila). 2024 Jul-Aug;19(4):371-379. doi: 10.1177/15569845241264565. Epub 2024 Aug 29.
We convened a group of cardiac surgeons, intensivists, and anesthesiologists with extensive experience in minimally invasive cardiac surgery (MICS) and perioperative care to identify the essential elements of a MICS program and the relationship with Enhanced Recovery After Surgery (ERAS). The MICS incision should minimize tissue invasion without compromising surgical goals. MICS also requires safe management of hemodynamics and preservation of cardiac function, which we have termed . Finally, comprehensive perioperative care through an ERAS program should be provided to allow patients to achieve optimal recovery. Therefore, we propose that MICS requires 3 elements: (1) a less invasive surgical incision (non-full sternotomy), (2) optimized myocardial management, and (3) ERAS. We contend that the full benefit of MICS can be achieved only by also utilizing an ERAS platform.
我们召集了一组心脏外科医生、重症监护医生和麻醉师，他们在微创心脏手术（MICS）和围手术期护理方面拥有丰富的经验，以确定 MICS 计划的基本要素及其与术后加速康复（ERAS）的关系。MICS 切口应最大限度地减少组织侵袭，同时不影响手术目标。MICS 还需要安全地管理血液动力学并保护心脏功能，我们称之为 。最后，通过 ERAS 计划提供全面的围手术期护理，以使患者实现最佳康复。因此，我们提出 MICS 需要 3 个要素：（1）微创的手术切口（非全胸骨切开术），（2）优化的心肌管理，和（3）ERAS。我们认为，只有利用 ERAS 平台，才能充分发挥 MICS 的优势。
