Perfusion challenges for minimally invasive cardiac surgery-single centre experience of 32 cases

With the advent of the era of minimally invasive cardiac surgery (MICS), new challenges for perfusion technology are emerging. In the increasing quest for safe cardiac surgery through a small incision for patient benefit, hardware and technique modification for cardiopulmonary bypass (CPB) are mandatory.

We present our experience of first thirty-two cases of MICS through a small right or left minimal lateral (3 inches) thoracotomy using femoro-femoral approach for CPB. Of the thirty-two cases, ten underwent coronary artery bypass grafting (CABG), sixteen had mitral valve replacement (MVR), three had MVR with tricuspid valve repair and three underwent aortic valve replacement (AVR).

There was no mortality in the series. One patient required conversion to midline sternotomy due to pleural adhesions. CPB was successfully managed in all patients. As per observation discomfort reported by the patient, intensive care unit (ICU) stay and hospital stay were less compared to conventional procedures. The article describes special problems encountered and solutions.