Fast-track congenital heart operations: a less invasive technique and early extubation

Marianeschi, Stefano; Seddio, Francesco; McElhinney, Doff B.; Colagrande, Luisa; Abella, Raúl; Torre, Teresa de la; Meli, Marco; Iorio, Fiore S.; Marcelletti, Carlo

doi:10.1016/s0003-4975(99)01330-2

Cited by 38 publications

(23 citation statements)

References 13 publications

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“…It is possible that, considering the exposure, the observed tendency of a SAMPAIO, LCN ET AL -Comparative study between inverted "L" mini-sternotomy and complete sternotomy for the surgical treatment of the atrial septal defect (ASD) shorter hospital stay would not be statistically significant. Our data are similar to other studies in which there were not distinctions in the protocol of hospital release between the two studied groups [10,14,20], although there are reports of shorter times in the ICU and in the hospital [17,18,20], all being results of specific protocols of early hospital release.…”

Section: Statistic Analysissupporting

confidence: 91%

Estudo comparativo entre a miniesternotomia em "L" invertido e esternotomia longitudinal total na correção cirúrgica da comunicação interatrial

Sampaio¹,

Carvalho²,

Alves³

et al. 2005

Rev Bras Cir Cardiovasc

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Objective: To compare the results obtained from two distinct surgical approaches in patients undergoing surgical correction of an atrial septal defect (ASD).Method: The study series consisted of 20 patients, with a mean age of 24.1 ± ± ± ± ± 14.2 years, distributed in two groups. In group A, 10 patients (80% female, with a mean age of 20.9 ± ± ± ± ± 12.0 years) underwent surgical correction of ASD through a complete sternotomy. In group B, 10 patients (80% of females, with a mean age of 27.4 ± ± ± ± ± 16.1 years) were operated through an inverted 'L' ministernotomy. A p-value < 0.05 was considered statistically significant.Results: There was no statistical significance for demographics variables, duration of surgery, cardiopulmonary bypass time, clamping time, amount of cardioplegia administered, thoracic drainage, ICU stay, duration of mechanical ventilatory support, amount of blood and its components transfused, arrhythmia or pacemaker usage. There was statistical significance (p= 0.00001) between incision size performed by complete sternotomy (group A) and inverted 'L' mini-sternotomy (group B), with mean incision sizes of 15.7 ± ± ± ± ± 0.8 and 6.8 ± ± ± ± ± 0.6 cm, respectively. There was a difference in the mean hospital stay between the groups but without statistical significance (7.5 ± 1.6 days in group A and 6.4 ± 1.3 days in group B, with a p-value = 0.12). There was no mortality or complications reported in either surgical approach.Conclusion: There was no difference in the operative and postoperative periods between the techniques that were performed except for the incision size, with a better cosmetic result seen with the inverted 'L' ministernotomy.Descriptors: Heart septal defects, atrial, surgery. Surgical procedures, minimally invasive surgery. Resumo Objetivo: Comparar os resultados obtidos entre duas vias de acesso cirúrgico em pacientes submetidos à correção cirúrgica de comunicação interatrial (CIA).Método: Foram distribuídos 20 pacientes, com média de idade de 24,1± ± ± ± ±14,2 anos, em dois grupos. No grupo A, 10 pacientes (80% do sexo feminino, com média de idade de 20,9 ± ± ± ± ± 12,0 anos) foram submetidos à correção da CIA por meio de uma esternotomia longitudinal total. No grupo B, 10 pacientes (80% do sexo feminino, com média de idade de 27,4Estudo comparativo entre a miniesternotomia em "L" invertido e esternotomia longitudinal total na correção cirúrgica da comunicação interatrialComparative study between inverted "L" ministernotomy and complete sternotomy for the surgical treatment of the atrial septal defect (ASD) 47 SAMPAIO, LCN ET AL -Comparative study between inverted "L" mini-sternotomy and complete sternotomy for the surgical treatment of the atrial septal defect (ASD) Braz J Cardiovasc Surg 2005; 20(1): 46-51

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Section: Statistic Analysissupporting

confidence: 91%

Estudo comparativo entre a miniesternotomia em "L" invertido e esternotomia longitudinal total na correção cirúrgica da comunicação interatrial

Sampaio¹,

Carvalho²,

Alves³

et al. 2005

Rev Bras Cir Cardiovasc

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“…The aims of a fast-track programme are the simplification of postoperative care [1,3] and, it is hoped, an increase patient and parent satisfaction. There are also theoretical economic considerations in terms of more cost-efficient care [4], associated with reduced consumption of intensive care and hospital resources.…”

Section: Discussionmentioning

confidence: 99%

“…Same-day discharge from the cardiac intensive care unit (CICU) to the high dependency unit (HDU) on the cardiology ward. Early de-intensification (optimal analgesia, early liberalisation from fluids and early mobilisation) [3]. Earlier discharge from hospital [4].…”

Section: Introductionmentioning

confidence: 99%

Fast-track paediatric cardiac surgery: the feasibility and benefits of a protocol for uncomplicated cases

Howard

Brown

Garside

et al. 2010

European Journal of Cardio-Thoracic Surgery

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“…Despite increasing evidence that fast-tracking in surgery for CHD can be achieved safely, [42,44,46,[62][63][64] there still remains significant individual as well as institutional concerns about the safety of such an approach. Large series in adult cardiac surgery have shown that fast-tracking can be accomplished safely and may actually benefit the patient.…”

Section: Concerns and Safety Of Fast-trackingmentioning

confidence: 99%

Fast-tracking in pediatric cardiac surgery - The current standing

Mittnacht

Hollinger

2010

Ann Card Anaesth

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Fast-tracking in cardiac surgery refers to the concept of early extubation, mobilization and hospital discharge in an effort to reduce costs and perioperative morbidity. With careful patient selection, fast-tracking can be performed in many patients undergoing surgery for congenital heart disease (CHD). In order to accomplish this safely, a multidisciplinary coordinated approach is necessary. This manuscript reviews currently used anesthetic techniques, patient selection, and available information about the safety and patient outcome associated with this approach.

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Fast-track congenital heart operations: a less invasive technique and early extubation

Cited by 38 publications

References 13 publications

Estudo comparativo entre a miniesternotomia em "L" invertido e esternotomia longitudinal total na correção cirúrgica da comunicação interatrial

Estudo comparativo entre a miniesternotomia em "L" invertido e esternotomia longitudinal total na correção cirúrgica da comunicação interatrial

Fast-track paediatric cardiac surgery: the feasibility and benefits of a protocol for uncomplicated cases

Fast-tracking in pediatric cardiac surgery - The current standing

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