Robotic cardiac surgery in Brazil

Abstract

Background: Brazil, the largest country and economy in South America, is a major driving force behind the development of new medical technologies in the region. Robotic cardiac surgery (RCS) has been evolving rapidly since 2010, when the first surgery using the DaVinci ® robotic system was performed in LatinAmerica. The aim of this article is to evaluate short and mid-term results in patients undergoing robotic cardiac surgery in Brazil.Methods: From March 2010 to December 2015, 39 consecutive patients underwent robotic cardiac surgery. Twenty-seven patients were male (69.2%), with the mean age of 51.3±17.9 years. Participants had a mean ejection fraction of 62±5%. The procedures included in this study were mitral valve surgery, surgical treatment of atrial fibrillation, atrial septal defect closure, resection of intra-cardiac tumors, totally endoscopic coronary artery bypass and pericardiectomy.Results: The mean time spent on cardiopulmonary bypass (CPB) during RCS was 154.9±94.2 minutes and the mean aortic cross-clamp time was 114.48±75.66 minutes. Thirty-two patients (82%) were extubated in the operating room immediately after surgery. The median intensive care unit (ICU) length of stay was 1 day (ranging from 0 to 25) and the median hospital length of stay was 5 days (ranging from 3 to 25). For each type of procedure, endpoints were individually reported. There were no conversions to sternotomy and no intra-operative complications. Patient follow-up was complete in 100% of the participants, with two early deaths unrelated to the procedures and no re-operations at mid-term.Conclusions: Despite the heterogeneity of this series, RCS appears to be feasible, safe and effective when used for the correction of various intra-and extra-cardiac pathologies. Adopting the robotic system has been a challenge in Brazil, where its limited clinical application may be related to the lack of specific training and the high cost of technology.

Transesophageal echocardiography in robot-assisted mitral valve repair for Barlow’s disease: usefulness for predicting artificial ring size and artificial chordae length using the loop technique

“…TEE is known to be very useful for immediate intraoperative evaluation in robot-assisted surgery [ 14 – 16 ]. Three-dimensional TEE is highly effective for observing the mitral complex structure [ 17 ].…”

O presente e o futuro da Enfermagem no Admirável Mundo Novo

“…In Brazil, this process began in the private network in 2008 with the incorporation of robotics in surgeries, in which 3,651 individuals have used this type of procedure in a single private hospital (11) . This technology is present in the states of Ceará, Rio de Janeiro, Rio Grande do Sul and São Paulo, and the Unified Health System (SUS -Sistema Único de Saúde) has also offered this type of service since 2011 (12) .…”

Associação entre força muscular respiratória e força de preensão palmar em pacientes submetidos à cirurgia cardíaca

“…Nos últimos anos, foi observado um aumento expressivo de indivíduos com problemas cardíacos que necessitavam de cuidados intensivos, clínicos ou cirúrgicos. 1 A cirurgia cardíaca (CC) é um procedimento complexo que apesar da sua evolução tecnológica, ocasiona importantes repercussões que podem conduzir a um estado crítico pós-operatório (PO), requerendo cuidados intensivos 2 , exigindo cuidados intensivos a fim de se estabelecer adequada recuperação. 3 As complicações no PO envolvem extenso comprometimento da função pulmonar e ainda são de alta prevalência.…”