3D video-assisted thoracoscopic cardiac surgery, a report of 50 cases / 中华胸心血管外科杂志

ABSTRACT

Objective To evaluate safety and validity of 3D video-assisted thoracoscopic technology in cardiac surgery.Methods Between October 2013 and July 2014,50 patients underwent 3 D Video-assisted thoracoscopic cardiac surgery including5 atrial septal defect closure,1 ventricular septal defect closure,repairment of 1 unroofed coronary sinus,1 partial atrioventricular septal defect and 1 cor triatriatum,28 mitral valve replacement (1 re-MVR),1 tricuspid valve replacement,9 mitral valvuloplasty,2 left atrial myoxoma resection,and 1 left internal mammary artery harvest + minimally invasive direct coronary artery bypass.All procedures were performed under extracorporeal circulation,using 30° thoracoscope and 3D high resolution monitor.Results There was no perioperative death.One patient was converted to median sternotomy because of pericardial adhesions.Mean operative time was(232.8 ± 54.7) min,mean cardiopulmonary bypass time was(128.0 ±42.5) min,mean aortic cross-clamp time was (74.7 ± 25.1) min.Mean ICU stay was (30.4 ± 22.0) h,mean duration of mechanical ventilation was(13.7 ± 11.9) h.Mean postoperative drainage time was (3.34 ± 1.91) d,mean hospital stay was (6.52 ± 3.06) days.There were 11 (22％) operative complications,including 4 intrathoracic bleeding,1 wound infection,3 hemothorax,1 brachial plexus injury,1 intractable hiccup and 1 mild paravalvular leakage.Compared with 20 mitral valve replacement by 2D thoracoscopy,the 3 D group was slightly less time consuming(P ＞ 0.05).Conclusion 3 D video-assisted thoracoscopic cardiac surgery is feasible and safe,and it' s worthwhile to promote this promising technology.