Cirurgia cardíaca videoassistida: resultados de um projeto pioneiro no Brasil

Abstract

Results: The surgical procedures were: plasty (n=20) or mitral valve replacement (n=36), aortic valve replacement (n=14), atrioseptoplasty using pericardial patch (n=32), tricuspid valve repair with rigid ring (n=6) and surgical correction of atrial fibrillation with radiofrequency (n=12). There were no complications during the procedures. There was no conversion to thoracotomy in neither case. Two patients developed atrial fibrillation in the postoperative period. There was an episode of stroke seven days after the hospital discharge and one death (0,9%) due to systemic inflammatory response syndrome (SIRS).Conclusion: This study demonstrates the coverage of pathologies that are possible to be approached by videoassisted cardiac surgery with cardiopulmonary bypass being a safe and effective procedure with low morbimortality. Minimally invasive video-assisted cardiac surgery is already a reality in Brazil, demonstrating excellent aesthetic and functional results. Rev Bras Cir Cardiovasc 2009; 24(3): 318-326 and transesophageal echocardiogram, ultrasound of the carotid arteries, abdominal, iliac and femoral arteries. In patients with suspicion of some obstruction of peripheral arteries, angiotomography of the thoracoabdominal aorta was requested. Special care was taken at the time of cardiac catheterization, avoiding puncturing the femoral vessels, giving preference to puncture of the radial artery and complete aortography was performed during the exam. After the first 40 cases, we included patients with an ejection fraction below 55%, emergencies, reoperations and obese patients.The age ranged from 18 to 68 years, and 57 patients were female (55.8%).

Cirurgia cardíaca videoassistida

“…In the group of congenital heart disease, those times were even lower, with 1.3 ± 0.5 days in ICU and 2.6 ± 0.8 days of postoperative hospitalization, numbers that demonstrate the expected result for this technique. Argenziano et al [41] reported 20 hours of admission and 4 days of hospitalization, Modi et al [40], six days of hospitalization, and Poffo et al [39], 6.5 days of hospitalization.…”

“…Only since 2005, with the beginning of our experience [16,37,38] and the experience of Poffo et al [39] in 2006, a new era of video-assisted cardiac surgery in our country has began, including intracardiac procedures via peripheral CPB, vacuum assist and minithoracotomy.…”

Robotic assisted minimally invasive surgery for atrial septal defect correction

“…Disposable pads for external cardiac defibrillation were placed in the region of the right scapula and anterolateral hemithorax. We performed the passage of nasopharyngeal thermometer and transesophageal transducer [2].…”

Cirurgia cardíaca minimamente invasiva no Brasil

“…The concern about the safety of direct aortic cannulation during surgery with smaller incisions was approached by Guedes et al [8], which demonstrated the method safety. Poffo et al [9] recently published their experience in this area, demonstrating a range of possible operations to be performed through a minimally invasive manner with peripheral cannulation, without complications due to cannulation and with good postoperative results. The same group demonstrated the possibility of performing the correction of associated heart diseases [10], as well as more complex techniques are also employed in minimally invasive manner [11].…”