Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 104
Filtrar
1.
Artigo em Inglês | MEDLINE | ID: mdl-38802045

RESUMO

OBJECTIVES: We compared the clinical outcomes of mitral valve repair for mitral regurgitation via the robot-assisted approach and small right thoracotomy approach 3 years after the reimbursement of the robot-assisted approach in Japan. METHODS: Patients who underwent isolated mitral valve repair by minimally invasive approach between 2018 and 2020 from the Japan Cardiovascular Surgery Database were included. Patients in the robot-assisted approach group were matched to the small right thoracotomy approach group based on propensity scores estimated from patient and surgical characteristics. Perioperative outcomes were compared among all cases as well as in subgroups categorized on the basis of the yearly number of robot-assisted approach cases and small right thoracotomy approach cases (≥10 or <10) at the hospital. RESULTS: We identified 2443 patients who had undergone isolated mitral valve repair at 250 institutions in the database, and analysis of propensity-matched 577 patient-pairs demonstrated that operation time, cardiopulmonary bypass time, and aortic crossclamp time were significantly shorter with the robot-assisted approach. Although the intensive care unit stay was longer in the robot-assisted approach, the time to discharge was significantly shorter in the robot-assisted approach. There was no meaningful difference in the in-hospital mortality. The incidences of postoperative stroke, renal failure, and prolonged ventilation, and the number of patients who converted to mitral valve replacement were similarly low. Procedural time, blood transfusions, explorative procedures for bleeding, postoperative stroke, and prolonged ventilation occurred at a lower rate in the high-volume institutions. CONCLUSIONS: The study found that the robot-assisted approach is just as effective as the small right thoracotomy approach. The introduction of robot-assisted mitral valve repair in Japan has been successful.

2.
Asian J Endosc Surg ; 17(1): e13255, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37871909

RESUMO

INTRODUCTION: Traditional surgical methods have been difficult for patients with chest wall deformities, but the use of the Electrical Sternum Lifting System (ESLS) has made the surgery easier. MATERIALS AND SURGICAL TECHNIQUE: Patients with a sternum-to-vertebral distance of less than 80 mm on preoperative computed tomography (CT) scan routinely underwent sternal lift using the ESLS. The ESLS was effective in securing the operative field while suspending the sternum, allowing adequate observation of the left atrium, left ventricle, and the mitral valve, and safe mitral valve plasty. The use of the lifting device did not interfere with the robot arms, and the space between the sternum and vertebrae was widened with only a 3 mm wound to move the mitral valve surface in the sagittal plane, making the repair easy and accurate under robotic assistance. The effort to attach the ESLS was not difficult, and the postoperative cosmetic outcomes were excellent. Sixty-three out of 1002 patients (6.3%) underwent sternal elevation using ESLS. There were 19 males and 44 females with a mean age of 50.9 ± 14.0 years. The average of sternum-to-vertebral (S/V) distance was 72.4 ± 8.9 cm. Two patients had S/V distance of more than 80 mm but ESLS was used because of scoliosis.


Assuntos
Tórax em Funil , Procedimentos Cirúrgicos Robóticos , Robótica , Masculino , Feminino , Humanos , Adulto , Pessoa de Meia-Idade , Tórax em Funil/cirurgia , Depressão , Remoção , Resultado do Tratamento , Esterno/cirurgia , Esterno/anormalidades
3.
JTCVS Tech ; 22: 16-22, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38152230

RESUMO

Objective: To present our strategy and the clinical outcomes of robot-assisted Barlow mitral valve keyhole surgery. Methods: From May 2015 to March 2022, a total of 1281 patients underwent mitral valve repair at our institution, including 763 with robotics surgeries. Of these, 124 patients with Barlow mitral valve (49 ± 12 years, male/female ratio = 81:43) were treated using robotic assistance and included in this study. Results: All operations were completed using 3 to 5 keyholes. Neochordae implantation using the loop technique was the first option, and resection was performed only in cases with an intrinsic risk of developing systolic anterior motion. Neochordae implantation was performed in 118 cases (95.1%) using 6.6 ± 3.0 neochordae. Posterior leaflet resection was performed in 27 (21.7%) patients. Operation time was 177 ± 42 minutes, cardiopulmonary bypass time was 127 ± 25 minutes, and aorta crossclamp time was 76 ± 16 minutes. Blood transfusion was required in 5 cases (4%). None of the patients required a conversion to valve replacement. The postoperative complications included bleeding (n = 4), stroke (n = 1), and infection (n = 2). Mitral valve regurgitation 1 week after repair was none or trivial in 122 cases (98.3%), mild in 2 cases (1.7%), and more than moderate in 0 cases. Freedom from reoperation was 99.2% during the follow-up period of 36 ± 21 months. One patient required reoperation due to infective endocarditis. Conclusions: Robot-assisted keyhole surgery using the loop-first concept was adequate to help achieve satisfactory and safe perioperative outcomes for Barlow mitral valve.

4.
Innovations (Phila) ; 18(4): 380-383, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37534405

RESUMO

A 63-year-old woman was referred to our institution for surgical treatment of triple valve (aortic, mitral, and tricuspid) insufficiency and underwent a robot-assisted endoscopic procedure. Three intercostal ports were placed in the right lateral chest for robotic instruments and a retrograde cardioplegic cannula, and a 5 cm thoracotomy was made for the procedure, which was a mitral valve repair with neochords and ring annuloplasty, an aortic valve replacement with bioprosthetic valve, and a ring tricuspid annuloplasty. Surgery was successfully achieved without blood transfusion or any complications.


Assuntos
Doenças das Valvas Cardíacas , Implante de Prótese de Valva Cardíaca , Anuloplastia da Valva Mitral , Insuficiência da Valva Mitral , Procedimentos Cirúrgicos Robóticos , Insuficiência da Valva Tricúspide , Feminino , Humanos , Pessoa de Meia-Idade , Insuficiência da Valva Mitral/cirurgia , Insuficiência da Valva Mitral/complicações , Doenças das Valvas Cardíacas/cirurgia , Valva Mitral/cirurgia , Insuficiência da Valva Tricúspide/cirurgia , Implante de Prótese de Valva Cardíaca/métodos , Resultado do Tratamento
5.
Ann Thorac Surg ; 115(4): e93-e95, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-35447120

RESUMO

We experienced 3 cases of port-access robot-assisted totally endoscopic technique for mitral valve repair and concomitant coronary artery bypass. The right internal mammary artery was harvested, mitral valve was fixed, and the right internal mammary artery to right coronary artery anastomosis was carried out on the arrested heart. The use of cardiac arrest and a V-shaped hook technique facilitated the coronary anastomosis and the da Vinci Firefly test (Intuitive Surgical Inc., Sunnyvale, CA) could confirm patency of the graft.


Assuntos
Parada Cardíaca , Robótica , Humanos , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgia , Ponte de Artéria Coronária/métodos , Endoscopia/métodos , Vasos Coronários/cirurgia
6.
Gen Thorac Cardiovasc Surg ; 71(2): 145-148, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36309920

RESUMO

Intraoperative water testing is essential for assessing mitral valve morphology and degree of residual mitral regurgitation during mitral valve repair. However, in some cases, evacuating intracardiac air is challenging. Herein, we report the routine de-airing method during total endoscopic robot-assisted mitral valve repair at our institute and discuss its effectiveness. In brief, our de-airing methods involve the following steps: after restricting the blood flow of the cardiopulmonary bypass, intracardiac air was pushed out into the pulmonary veins by drawing blood from the right ventricle. The left atrium, left ventricle, and ascending aorta were filled with blood to remove air from the root cannula. Retrograde blood flow from the coronary sinus was used to remove air from the coronary arteries. At 10 min after cardiopulmonary bypass weaning, transesophageal echocardiography revealed that residual intracardial air was absent in 99% of patients in all three chambers (ascending aorta, left atrium, and left ventricle).


Assuntos
Procedimentos Cirúrgicos Cardíacos , Insuficiência da Valva Mitral , Robótica , Humanos , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgia , Ecocardiografia Transesofagiana , Insuficiência da Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/cirurgia
8.
Kyobu Geka ; 75(7): 489-495, 2022 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-35799483

RESUMO

Endoscopic surgery has been introduced as a minimally invasive procedure in other fields. On the other hand, the introduction of surgical robots has made endoscopic surgery possible in cardiac surgery. Coronary artery bypass surgery includes minimally invasive direct coronary artery bypass( MIDCAB) via small thoracotomy after robotic internal thoracic artery harvesting and totally endoscopic coronary artery bypass with a robotic anastomosis. We refer to intracardiac surgery performed via only ports as "keyhole cardiac surgery". Robotic keyhole mitral valve repair is far superior to median sternotomy or minimally invasive cardiac surgery( MICS). Currently, the "da Vinci surgical system" is the sole leader in surgical robotics, but there are already many surgical robots, including new concepts. In Japan, the "hinotori surgical robot system" is already on the market, and it is expected that the indications for surgery will expand in the future.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Procedimentos Cirúrgicos Robóticos , Robótica , Ponte de Artéria Coronária/métodos , Humanos , Japão , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Resultado do Tratamento
9.
Asian J Endosc Surg ; 15(4): 809-811, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35488502

RESUMO

A 21-year-old female patient referred to our institute had been suffering from severe mitral valve regurgitation due to a rare anomaly: a typical cleft at the posterior mitral leaflet and the other partial one at the anterior leaflet. We successfully fixed the mitral valve using the robot-assisted totally endoscopic technique which could perform suture closure of both leaflets and annuloplasty. This communication is the first report of the robotic and totally endoscopic procedure which could treat this rare mitral anomaly.


Assuntos
Anuloplastia da Valva Mitral , Insuficiência da Valva Mitral , Procedimentos Cirúrgicos Robóticos , Robótica , Adulto , Feminino , Humanos , Valva Mitral/anormalidades , Valva Mitral/cirurgia , Anuloplastia da Valva Mitral/métodos , Insuficiência da Valva Mitral/cirurgia , Adulto Jovem
10.
Interact Cardiovasc Thorac Surg ; 34(2): 326-328, 2022 01 18.
Artigo em Inglês | MEDLINE | ID: mdl-34535996

RESUMO

We report a bilateral thoracoscopic technique in which robot-assisted mitral valve repair was achieved concomitantly with stapler division of the large left atrial appendage. The patient was a 65-year-old male with severe mitral regurgitation, paroxysmal atrial fibrillation and a large-sized atrial appendage. Closure of the appendage was completed off-pump using a left thoracoscopic stapler-division technique previous to right thoracoscopic robot-assisted mitral valve repair and cryoablation. Complete closure of the appendage was confirmed in thoracoscopic views. The bilateral thoracoscopic technique could be preferable for the minimally invasive treatment of mitral valvular disease and concomitant large-sized atrial appendage management.


Assuntos
Apêndice Atrial , Fibrilação Atrial , Robótica , Idoso , Apendicectomia , Apêndice Atrial/diagnóstico por imagem , Apêndice Atrial/cirurgia , Fibrilação Atrial/diagnóstico por imagem , Fibrilação Atrial/cirurgia , Átrios do Coração/cirurgia , Humanos , Masculino , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgia
11.
JA Clin Rep ; 7(1): 41, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33932160

RESUMO

BACKGROUND: Various attempts have been made to meet patient desires, especially among younger and otherwise healthy individuals, for cosmetically satisfying incision with atrial septal defect (ASD) repair. One of procedures was a robotic-assisted totally endoscopic ASD repair via only two ports under hyperkalemic arrest without aortic cross-clamping. This study investigated perioperative management and safety for robotic-assisted total endoscopic ASD repair surgery under hyperkalemic arrest. METHODS: We retrospectively reviewed perioperative management of thirty patients who underwent total endoscopic robot-assisted ASD repair under hyperkalemic arrest. All procedures were performed under general anesthesia using robotic-assisted total endoscopic for ASD repair via two or three ports under hyperkalemic arrest without aortic cross-clamping. RESULTS: A total of 30 patients (mean age 45 ± 17 years, 8 male, 22 female) underwent successful ASD repair with the total endoscopic robotic-assisted procedures under hyperkalemic arrest. Hyperkalemic arrest was achieved and maintained by intravenous administration of mean potassium dose of 91±32 mEq (1.4±0.6 mEq/kg) with the lowest bladder temperature was 31.9±1.4 °C during hyperkalemic arrest. In all cases, serum potassium concentration was <5.0 mEq/L after weaning from cardiopulmonary bypass, although two cases who developed hyperkalemia >6 mEq/L after operation. At other time points, no patient exceeded 6 mEq/L of serum potassium concentration. At admission to the intensive care unit, mean serum creatine phosphokinase-MB level was 32±7mg/dL. There were no cases of arrhythmia or other cardiac complications during recovery. CONCLUSIONS: Perioperative management of robotic-assisted total endoscopic ASD repair under hyperkalemic arrest is safe and is not associated with fatal arrhythmia due to hyperkalemia.

12.
Artif Organs ; 45(6): 633-636, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33349971

RESUMO

Pectus excavatum (PE) can be associated with cardiac disorders that also require surgical repair. Totally endoscopic robot-assisted mitral valve plasty for mitral valve regurgitation was performed while elevating the sternum with the aid of our original electrical sternum lifting system. Then, the Nuss procedure was performed successfully via small incision. Simultaneous robot-assisted cardiac surgery and the Nuss procedure is effective. Sternal elevation during cardiac surgery is very important for a safe procedure. The Nuss technique prevents perioperative cardiac compression and allows for correction of the pectus deformity with good cosmetic and functional results.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Tórax em Funil/cirurgia , Insuficiência da Valva Mitral/cirurgia , Procedimentos Cirúrgicos Robóticos/métodos , Feminino , Tórax em Funil/complicações , Humanos , Pessoa de Meia-Idade , Insuficiência da Valva Mitral/etiologia
13.
Circ J ; 83(8): 1668-1673, 2019 07 25.
Artigo em Inglês | MEDLINE | ID: mdl-31231117

RESUMO

BACKGROUND: In 2018, Japan became the first country to have robotic cardiac surgery covered under the national health insurance. The number of patients undergoing robotic mitral valve (MV) repair has been estimated to increase remarkably, but no reports in Japan have yet described the outcomes of robotic MV repair. This study aimed to analyze the early clinical outcomes of patients undergoing totally endoscopic robotic MV repair (TERMVR) as a landmark national study for this procedure.Methods and Results:A total of 213 patients (152 men; mean age, 55±11 years) underwent TERMVR during May 2014 to December 2018. Preoperative demographics, operative profiles, and postoperative outcomes, including follow-up echocardiography, were analyzed. Successful TERMVR was achieved in all patients. Operation, cardiopulmonary bypass, and aortic cross-clamp times were 192±49.8, 127±23.8, and 70.1±16.2 min, respectively. Intraoperative transfusion was performed in 20 patients (10%). There were no in-hospital deaths. All patients were alive during the median follow-up period of 255 days (interquartile range, 32.5-208 days). Freedom from recurrence of MR >grade 2+ was 97.3%, 95.0%, and 90.7% at 6, 12, and 24 months, respectively. CONCLUSIONS: TERMVR is an effective and safe procedure with acceptable early postoperative outcomes.


Assuntos
Endoscopia , Implante de Prótese de Valva Cardíaca , Anuloplastia da Valva Mitral , Insuficiência da Valva Mitral/cirurgia , Valva Mitral/cirurgia , Procedimentos Cirúrgicos Robóticos , Adulto , Idoso , Endoscopia/efeitos adversos , Feminino , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/diagnóstico por imagem , Valva Mitral/fisiopatologia , Anuloplastia da Valva Mitral/efeitos adversos , Insuficiência da Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/fisiopatologia , Complicações Pós-Operatórias/etiologia , Intervalo Livre de Progressão , Recuperação de Função Fisiológica , Recidiva , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Fatores de Tempo , Tóquio
15.
Innovations (Phila) ; 14(1): 55-59, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30848715

RESUMO

OBJECTIVES: Endoscopic knot tying can complicate or prolong minimally invasive surgical procedures. A novel shape-memory monofilament suture with a spiral tail has been developed to speed up suture fixation during minimally invasive cardiac surgery. The purpose of this study was to evaluate its usefulness and safety in minimally invasive cardiac surgery. METHODS: We installed a needle with a 4-0 monofilament suture, composed of polyvinylidene difluoride and hexafluoropropylene copolymers, in an originally invented jig and heated it in an oven. By only passing through the needle and then into the spiral made at the tail of the suture, a hangman's knot was easily made. For the fundamental experiment, to evaluate the effectiveness of the novel shape-memory monofilament suture, 4 surgeons with varying thoracoscopic experience tied knots within a simulated minimally invasive setting, using both the novel shape-memory and conventional monofilament sutures. The time elapsed for knot tying and tensile strength of each knot was measured. RESULTS: The mean knot-tying time was significantly shorter with the novel suture than with the conventional suture (108 ± 29 vs. 172 ± 42 seconds, P = 0.01). The ultimate tensile strength of each knot was 17.4 N in the novel suture and 16.5 N in the conventional suture. CONCLUSIONS: The novel shape-memory monofilament suture has great potential for reducing operative time of minimally invasive thoracoscopic surgery while retaining the strength of the knot.


Assuntos
Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Técnicas de Sutura/instrumentação , Suturas/estatística & dados numéricos , Toracoscopia/métodos , Desenho de Equipamento , Humanos , Teste de Materiais/métodos , Cirurgiões , Técnicas de Sutura/tendências , Resistência à Tração
16.
Surg Today ; 49(1): 96-98, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30406844

RESUMO

We successfully performed totally endoscopic single-port robotic surgery. A 50-year-old man with a mediastinal tumor underwent robot-assisted tumor resection. Only one port was placed on the right side of the chest, and a robotic endoscope and two robotic instruments were inserted through the port. The instruments were crossed while avoiding collision. Single-port robotic surgery for a mediastinal tumor using the cross-arm technique was safely achieved with good clinical results and excellent cosmetic results.


Assuntos
Neoplasias do Mediastino/cirurgia , Procedimentos Cirúrgicos Robóticos/métodos , Cirurgia Torácica Vídeoassistida/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Robóticos/instrumentação , Resultado do Tratamento
17.
Heart Surg Forum ; 21(3): E145-E147, 2018 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-29893669

RESUMO

OBJECTIVE: The mitral valve plasty (MVP) technique for degenerative disease is typically leaflet resection and suturing. However, this technique is time consuming and unreproducible. To overcome this disadvantage, we developed a nonresectional folding technique, which is fast and reproducible. In this report, we examine our new folding technique in robotic MVP. METHODS: The new folding technique was performed in 10 patients (age 56 ± 15 years), and the conventional resection and suturing (RS) technique was performed in 22 patients (age 53 ± 8 years). In our new folding technique, we used two sutures to fold the prolapsed leaflet to the left ventricle side. The first folding suture line is a land mark, and the second line adjusts the height of the posterior leaflet to the anterior leaflet so that sufficient coaptation depth can be obtained. RESULTS: MVP was successful in all patients. In the folding technique group, the operation time, cardiopulmonary bypass time, and cross clamp time was faster than the conventional RS technique group (188 ± 31, 97 ± 32, and 55 ± 3 min, versus 242 ± 51, 137 ± 25, and 70 ± 15 min; P < .05). Hospital stays were significantly shorter in the folding technique group (13 ± 2 days versus 17 ± 7 days; P < .05). All patients were discharged without complications. The post-echocardiography revealed no mitral valve regurgitation in any patient. CONCLUSION: The new folding technique facilitated efficient MVP for posterior leaflet prolapse in mitral valve regurgitation, without the need for the resection of the leaflet.


Assuntos
Anuloplastia da Valva Mitral/métodos , Insuficiência da Valva Mitral/cirurgia , Valva Mitral/cirurgia , Procedimentos Cirúrgicos Robóticos/métodos , Técnicas de Sutura/instrumentação , Suturas , Ecocardiografia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/diagnóstico , Estudos Retrospectivos , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do Tratamento
18.
J Robot Surg ; 12(4): 741-744, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29307098

RESUMO

A 66-year-old woman was referred to our institute for an enlarging tumor of the thyroid, and neck and chest computed tomography scan showed not only a thyroid tumor, but also an anterior mediastinal tumor and ground-glass nodules in the lung. Because of persisting symptoms, an enlarging thyroid mass, and the possibility of cancer, excision of the tumors was proposed. A 6-cm-long vertical skin incision was made in the right axilla, a mini-thoracotomy was made in the third intercostal space, and an additional port was placed in the fifth intercostal space. Thoracoscopic partial resection of the right upper lobe of the lung was performed first. Then, the da Vinci surgical system (da Vinci, Intuitive Surgical Inc., Sunnyvale, CA, USA) was introduced through the mini-thoracotomy. The mediastinal tumor was then excised circumferentially robotically. After resection of the lung and mediastinal tumors, the da Vinci was undocked, and a subcutaneous tunnel from the axillary incision to the thyroid was created using the flap dissection technique. The da Vinci was re-introduced through the axillary incision. A long camera port was used, and the skin and muscle flap was elevated to maintain adequate working space during the robot-assisted thyroidectomy. Total operating time was 277 min, and the patient's postoperative course was uneventful. The histopathological examinations of the lung, mediastinal, and thyroid tumors were adenocarcinoma, thymolipoma, and adenomatous goiter, respectively. In conclusion, single-incision robotic surgery for three lesions was achieved safely with good clinical results and excellent cosmetic results.


Assuntos
Axila/cirurgia , Neoplasias Pulmonares/cirurgia , Neoplasias do Mediastino/cirurgia , Neoplasias Primárias Múltiplas/cirurgia , Procedimentos Cirúrgicos Robóticos/métodos , Toracoscopia/métodos , Neoplasias da Glândula Tireoide/cirurgia , Adenocarcinoma/cirurgia , Idoso , Feminino , Bócio/cirurgia , Humanos , Lipoma/cirurgia , Pneumonectomia/métodos , Tireoidectomia/métodos
19.
Interact Cardiovasc Thorac Surg ; 26(5): 721-724, 2018 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-29300963

RESUMO

OBJECTIVES: Atrial septal defect (ASD) repairs have been successfully performed on arrested hearts with robotic assistance. The present study assessed the feasibility, safety, and efficacy of totally endoscopic cardiac surgery using a no-touch aorta technique for ASD via only 2 ports, and we named this procedure two-port robotic cardiac surgery (TROCS). METHODS: Between May 2014 and June 2016, 8 consecutive patients underwent TROCS for ASD using the da Vinci surgical system (Intuitive Surgical Inc.) at our institute. All of the procedures were performed via only 2 port incisions in the right chest. One was the camera port, and the other was the port for the robotic instruments. Both robotic instruments were inserted through this port and crossed while being prevented from colliding with each other. The surgeon console was set to the reverse of default settings so that both masters would control the inverse instrument. TROCS for ASD was carried out under ventricular fibrillation induced by combinations of an electrical fibrillator, injection of potassium, and hypothermia without aortic cross-clamping. RESULTS: All cases were successfully repaired. The mean operation, cardiopulmonary bypass and ventricular fibrillation times were 129.6 ± 29.0 min, 66.9 ± 24.5 min and 9.6 ± 5.9 min, respectively, and the estimated blood loss volume was 28.1 ± 58.6 ml. No patients required blood transfusion during their hospital stay, and their cosmetic results were excellent. CONCLUSIONS: TROCS for ASD using no-touch aorta technique was achieved safely with good clinical results and excellent cosmetic results.


Assuntos
Endoscopia/métodos , Comunicação Interatrial/cirurgia , Procedimentos Cirúrgicos Robóticos/métodos , Idoso , Ponte Cardiopulmonar , Estudos de Coortes , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
20.
Interact Cardiovasc Thorac Surg ; 26(1): 163-164, 2018 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-29049711

RESUMO

Isolated coronary artery bypass grafting associated with atrial fibrillation is routinely performed through a sternotomy, and cardiac arrest. Advancements in this surgical approach have led to better cosmesis, a quick postoperative recovery, with the same postoperative results. We report a case of a novel, less invasive hybrid treatment combining robot-assisted coronary artery bypass grafting and percutaneous radiofrequency catheter ablation.


Assuntos
Fibrilação Atrial/cirurgia , Ablação por Cateter/métodos , Ponte de Artéria Coronária/métodos , Estenose Coronária/cirurgia , Procedimentos Cirúrgicos Robóticos/métodos , Esternotomia/métodos , Idoso , Fibrilação Atrial/complicações , Fibrilação Atrial/diagnóstico , Angiografia por Tomografia Computadorizada , Estenose Coronária/complicações , Estenose Coronária/diagnóstico , Eletrocardiografia , Humanos , Imageamento Tridimensional , Masculino
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...