ABSTRACT
Objective: This study was done to show that open heart surgical procedures can be done through a small sternal incision. Design: This was a single center prospective study. Place and Duration of study: Department of cardiac surgery, National Institute of Cardiovascular Diseases, Karachi. The study was completed in two years i-e Jan 1998 to Dec 1999
Subjects and Methods: A total of 40 patients underwent open heart surgery via minimally invasive approach through a lower median sternotomy. Of these 22 patients had ASD Closures, 8 underwent CABG Surgery and 10 patients had MVR procedure. The approach was via a small incision 8-1 0cm in length from xiphoid upwards and asymetrical lower median sternotomy upto the 2[nd] 1. C. S. deviated from midline on to the right side
Results: 22 patients had ASD Closure of these 21 patients had secundum defects while 1 had sinus venosus defect. In IHD group 2 patients had single vessel disease and 6 patients had 2 vessel disease [LAD and RCA]. 10 patient had MVR of these 5 patient had MR while 5 had mixed lesions. These patients had less postoperative pain. Early mobilization was achieved. No incidence of sternal dehiscence was noted. The scar was cosmetically much better than the conventional sternotomy scar and was completely hidden under the shirt
Conclusion: Open heart surgery is possible through a minimally invasive procedure. The advantages of the procedure are less trauma, less postoperative pain, reduced risk of infection. Patient recovery is quick and excellent cosmetic result
ABSTRACT
A trial myxoma is a rare disease. This is a ten-year retrospective study carried out between January 1991 and December 2000. Our goals were to find out the incidence and long term results of this disease. 52 patients were identified with this condition during this period. The majority of patients were females 41 [78.8 percent] compared to males 11 [21.2 percent]. The mean age was 35 years [28-50 years]. The diagnosis was confirmed at 2D echocardiography surgical treatment entailed excision of the myxoma under CPB. All specimens were sent for histology. Complete excision of the myxoma was achieved in all patients. The incidence of malignancy was very small i.e.: 2 patients [3.84 percent]. The hospital mortality was 5.8 percent. The commonest complication was bleeding 11. 5 percent. There was no recurrence at 2 years follow up. Atrial myxoma is a curable disease. Once treated surgically, it has excellent long term prognosis