Short-term effect of minimally invasive thoracoscopic cardiac surgery in 453 patients: A retrospective study in a single center_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LAN Huai ,  WANG Zhenlong , YANG Wenju , LI Xiaomi , ZHANG Yong , WANG Yang , LIU Yu , SHI Yun

Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, Shenyang, 110016, P. R. China;

Corresponding?author：

WANG Zhenlong, Email: wangzl1976@sina.com

Keywords：

Thoracoscope; minimally invasive cardiac surgery; congenital heart disease; cardiac tumor

DOI：

10.7507/1007-4848.202204078

Video：

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Objective To analyze the short-term outcomes of cardiac surgery via minimally invasive approach under thoracoscope in a single-center. Methods The clinical data of patients who underwent cardiac surgery via minimally invasive approach under thoracoscope between July 2017 and February 2022 were retrospectively analyzed. Results A total of 453 patients were enrolled, including 150 males and 303 females at an average age of 42.2±14.6 years. The main disease types included atrial septal defect in 314 patients, partial atrioventricular septal defect in 26 patients, and cardiac tumor in 105 patients. There was no death during the perioperative period. The mean operative time was 3.9±0.8 h, cardiopulmonary bypass time was 101.2±34.0 min, aortic occlusion time was 42.1±25.1 min, ventilator assistance time was 11.6±9.4 h, ICU stay time was 22.6±13.9 h and postoperative hospital stay was 6.0±1.7 d. Intraoperative and postoperative complications occurred in 18 (4.0%) patients, including 2 patients with conversion to sternotomy, 3 with incision expand, 3 with reoperation for bleeding, 1 with of redo operation, 4 with incision infection, 2 with respiratory insufficiency, 2 with cerebrovascular accident, and 1 with ventricular fibrillation. The follow-up time was 22.6±15.4 months, during which 1 patient died, 4 patients had moderate mitral regurgitation, 1 patient had mild-moderate mitral regurgitation, and 1 patient had mild-moderate tricuspid regurgitation. Conclusion Minimally invasive cardiac surgery under thoracoscope is safe with small invasions and few complications, and has satisfactory short-term outcomes.

Citation： LAN Huai, WANG Zhenlong, YANG Wenju, LI Xiaomi, ZHANG Yong, WANG Yang, LIU Yu, SHI Yun. Short-term effect of minimally invasive thoracoscopic cardiac surgery in 453 patients: A retrospective study in a single center. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(12): 1703-1708. doi: 10.7507/1007-4848.202204078 Copy

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9.	崔輝敏, 張林, 魏士雄, 等. 連續100例胸腔鏡二尖瓣成形術早期臨床結果分析. 中華胸心血管外科雜志, 2021, 37(9): 542-545.
10.	Yu S, Xu X, Zhao B, et al. Totally thoracoscopic surgical resection of cardiac myxoma in 12 patients. Ann Thorac Surg, 2010, 90(2): 674-676.
11.	黃煥雷, 柯英杰, 楊亮, 等. 微創成形技術治療心臟手術后重度三尖瓣關閉不全的中期療效分析. 中華外科雜志, 2019, 57(12): 902-907.
12.	張林, 姜勝利, 李梁鋼, 等. 單操作孔全胸腔鏡治療左心瓣膜術后三尖瓣關閉不全臨床分析. 中華外科雜志, 2019, 57(12): 908-911.
13.	Casselman FP, Van Slycke S, Wellens F, et al. Mitral valve surgery can now routinely be performed endoscopically. Circulation, 2003, 108 Suppl 1:Ⅱ48-Ⅱ54.
14.	F?rber G, Tkebuchava S, Dawson RS, et al. Minimally invasive, isolated tricuspid valve redo surgery: A safety and outcome analysis. Thorac Cardiovasc Surg, 2018, 66(7): 564-571.
15.	Fang L, Li W, Zhang W, et al. Mid-term results and risks of isolated tricuspid valve reoperation following left-sided valve surgery. Eur J Cardiothorac Surg, 2018, 53(5): 1034-1039.
16.	易蔚, 雷蘭萍, 熊紅燕, 等. 胸腔鏡體外循環心臟手術團隊的培養模式及學習曲線研究. 中國體外循環雜志, 2018, 16(5): 302-306.

1. 蘭懷, 王鎮龍, 劉宇, 等. 單中心開展全胸腔鏡下體外循環心臟手術初期臨床效果. 中國心血管病研究, 2021, 19(1): 56-60.
2. 蘭懷, 程云閣, 賈寶成, 等. 完全胸腔鏡下二尖瓣置換術634例臨床分析. 中華外科雜志, 2016, 54(8): 609-612.
3. Abu-Omar Y, Fazmin IT, Ali JM, et al. Minimally invasive mitral valve surgery. J Thorac Dis, 2021, 13(3): 1960-1970.
4. Liu K, Sun H, Wang B, et al. Is tri-port totally thoracoscopic surgery for mitral valve replacement a feasible approach? Ann Cardiothorac Surg, 2021, 10(1): 149-157.
5. 徐學增, 易蔚, 李華, 等. 單中心全胸腔鏡微創手術治療先天性心臟病2543例臨床分析. 中華外科雜志, 2016, 54(8): 591-595.
6. 中華醫學會胸心血管外科學分會胸腔鏡微創心臟手術技術. 我國胸腔鏡微創心臟手術技術操作規范專家共識(征求意見稿第二版). 中國胸心血管外科臨床雜志, 2016, 23(4): 315-318.
7. Cheng Y, Chen H, Mohl W, et al. Totally endoscopic congenital heart surgery compared with the traditional heart operation in children. Wien Klin Wochenschr, 2013, 125(21-22): 704-708.
8. 楊禹, 葉聰, 楊承志, 等. 全胸腔鏡下單純左心耳閉合術預防非瓣膜性房顫合并高出血風險患者相關腦卒中的臨床研究. 首都醫科大學學報, 2023, 44(5): 795-802.
9. 崔輝敏, 張林, 魏士雄, 等. 連續100例胸腔鏡二尖瓣成形術早期臨床結果分析. 中華胸心血管外科雜志, 2021, 37(9): 542-545.
10. Yu S, Xu X, Zhao B, et al. Totally thoracoscopic surgical resection of cardiac myxoma in 12 patients. Ann Thorac Surg, 2010, 90(2): 674-676.
11. 黃煥雷, 柯英杰, 楊亮, 等. 微創成形技術治療心臟手術后重度三尖瓣關閉不全的中期療效分析. 中華外科雜志, 2019, 57(12): 902-907.
12. 張林, 姜勝利, 李梁鋼, 等. 單操作孔全胸腔鏡治療左心瓣膜術后三尖瓣關閉不全臨床分析. 中華外科雜志, 2019, 57(12): 908-911.
13. Casselman FP, Van Slycke S, Wellens F, et al. Mitral valve surgery can now routinely be performed endoscopically. Circulation, 2003, 108 Suppl 1:Ⅱ48-Ⅱ54.
14. F?rber G, Tkebuchava S, Dawson RS, et al. Minimally invasive, isolated tricuspid valve redo surgery: A safety and outcome analysis. Thorac Cardiovasc Surg, 2018, 66(7): 564-571.
15. Fang L, Li W, Zhang W, et al. Mid-term results and risks of isolated tricuspid valve reoperation following left-sided valve surgery. Eur J Cardiothorac Surg, 2018, 53(5): 1034-1039.
16. 易蔚, 雷蘭萍, 熊紅燕, 等. 胸腔鏡體外循環心臟手術團隊的培養模式及學習曲線研究. 中國體外循環雜志, 2018, 16(5): 302-306.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Short-term effect of minimally invasive thoracoscopic cardiac surgery in 453 patients: A retrospective study in a single center

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