Aasim Muhammad, Aziz Raheela, Mohsin Atta Ul, Khan Raheel, Zahid Ayesha, Ikram Jibran
Cardiac Surgery, Hayatabad Medical Complex Peshawar, Peshawar, PAK.
Cardiovascular Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK.
Cureus. 2024 Nov 28;16(11):e74659. doi: 10.7759/cureus.74659. eCollection 2024 Nov.
Background The adoption of minimally invasive cardiac surgery (MICS) has increased over the past 25 to 30 years, driven by advancements in technology and a growing understanding of its benefits. This study evaluates the outcomes of 144 elective MICS procedures performed between January 2019 and September 2024. Methods Patients underwent various surgical approaches, including upper mini-sternotomy, mini-thoracotomy, and sub-xiphoid access. Patient demographics, preoperative characteristics, and surgical outcomes were analyzed. A total of 144 MICS procedures were performed. Results The cohort had a mean age of 30.72 years, with a nearly equal gender distribution, indicating that MICS can be performed safely in Pakistani patients. The mean ejection fraction was 53.58%, with hypertension being the most common comorbidity (22.2%). Aortic cannulation was primarily utilized, and aortic valve replacement (AVR) was the most common procedure (44.4%). The mean cardiopulmonary bypass (CPB) time was 95.9 ± 56.3 minutes and the mean aortic cross-clamp time was 62.22 ± 57.004 minutes, demonstrating efficient procedural times. The overall incidence of complications was low, supporting the safety and efficacy of MICS. Conclusion Our findings suggest that MICS is a viable and effective approach for a diverse patient population, with favorable clinical outcomes. The results underscore the potential for MICS to become standard practice in cardiothoracic surgery. Future research should focus on long-term outcomes and the influence of comorbidities to further enhance MICS methodologies.
背景 在过去25至30年中，受技术进步以及对其益处的日益了解的推动，微创心脏手术（MICS）的应用有所增加。本研究评估了2019年1月至2024年9月期间进行的144例择期MICS手术的结果。方法 患者接受了各种手术方式，包括上半胸骨切开术、小切口开胸术和剑突下入路。分析了患者的人口统计学特征、术前特征和手术结果。共进行了144例MICS手术。结果 该队列的平均年龄为30.72岁，性别分布几乎相等，这表明MICS可以在巴基斯坦患者中安全进行。平均射血分数为53.58%，高血压是最常见的合并症（22.2%）。主要采用主动脉插管，主动脉瓣置换术（AVR）是最常见的手术（44.4%）。平均体外循环（CPB）时间为95.9±56.3分钟，平均主动脉阻断时间为62.22±57.004分钟，表明手术时间高效。并发症的总体发生率较低，支持了MICS的安全性和有效性。结论 我们的研究结果表明，MICS对于不同患者群体是一种可行且有效的方法，具有良好的临床结果。这些结果强调了MICS成为心胸外科标准手术的潜力。未来的研究应关注长期结果以及合并症的影响，以进一步改进MICS方法。
