Less invasive video assisted cardiac surgery a comparative study with the conventional approach

Abstract

Background-Vertical median sternotomy has been the best approach to cardiac surgery. While the conventional approach is traumatic, with many complications, using a video camera in surgery offers smaller incisions. Methods - Our study was a prospective and comparative one. Our sample consisted of 57 patients, divided into 2 groups, including 30 patients operated by vertical median sternomtomy and 27 patients operated by minimally invasive video-assisted surgery. Preoperative, operative and postoperative data were collected and analyzed. Results -The patients’mean age was 49.5+16.3 years in the minimally invasive video-assisted group and 43.4+16.7 in the vertical median sternotomy group. The most common sign among these patients was dyspnea. Asymptomatic patients represented 11% in the vertical median sternotomy group and 43% in the minimally invasive video-assisted group. Mitral valve surgery was in 63% patients of minimally invasive video-assisted and 66.6% of vertical median sternotomy group. The mean time of cardiopulmonary bypass was 119.52+44.5 min in the minimally invasive video-assisted group and 84.53+34.2 min in the vertical median sternotomy group. The mean time of aortic clamping in the minimally invasive video-assisted group was 94.56+40.8 min while it was 59.53+25.5 min in the vertical median sternotomy group. The mean time of mechanical ventilation was 4.7+1.8 hours in the minimally invasive video-assisted group and 7.9±2.4 hours in the vertical median sternotomy group. Postoperative pain disappeared on the 2nd postoperative day in (73%) of the minimally invasive video-assisted group cases and on the 5th day in (70%) of vertical median sternotomy group cases. The average hospital stay was 8.67+3.8 days in minimally invasive video-assisted and 13.8+5.0 days in vertical median sternotomy group. Faster recovery of physical activities after minimally invasive surgery was reported. Conclusion - The minimally invasive video-assisted is a simpler, safer and more effective procedure with excellent results and low morbidity. This procedure results in a short -er recovery time.