Cirurgia cardíaca videoassistida: resultados de um projeto pioneiro no Brasil

Autor: Andréia Agapito, Isaias Cidral, Renato Bastos Pope, Iosmar da Silva Júnior, Cláudio Alexandre Mokross, Fabiane Fukuti, Rafael Armínio Selbach, Robinson Poffo
Rok vydání: 2009
Předmět:
Zdroj: Brazilian Journal of Cardiovascular Surgery v.24 n.3 2009
Brazilian Journal of Cardiovascular Surgery
Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)
instacron:SBCCV
ISSN: 0102-7638
Popis: Objective: To demonstrate the possibilities of the use of videothoracoscopy in cardiac surgery using cardiopulmonary bypass (CPB). Methods: Between February 2006 and November 2008, 102 patients underwent consecutively minimally invasive video-assisted cardiac surgery. The cardiac pathologies approached were: mitral valvopathy (n=56), aortic (n=14), interatrial communication (IC) (n=32), six patients presented associated tricuspid insufficiency and 12 presented atrial fibrillation. The age ranged from 18 to 68 years and 57 were female. The surgical approach was: femoral arterial and venous cannulation, minithoracotomy ranging from four to six centimeters (cm) at the level of the 3° or 4° right intercostal space (RICS), depending on the pathology of the patient, between anterior axillary line and hemiclavicular line, submammary or right periareolar groove through the right breast and thoracoscopy. Results: The surgical procedures were: plasty (n=20) or mitral valve replacement (n=36), aortic valve replacement (n=14), atrioseptoplasty using pericardial patch (n=32), tricuspid valve repair with rigid ring (n=6) and surgical correction of atrial fibrillation with radiofrequency (n=12). There were no complications during the procedures. There was no conversion to thoracotomy in neither case. Two patients developed atrial fibrillation in the postoperative period. There was an episode of stroke seven days after the hospital discharge and one death (0,9%) due to systemic inflammatory response syndrome (SIRS). Conclusion: This study demonstrates the coverage of pathologies that are possible to be approached by videoassisted cardiac surgery with cardiopulmonary bypass being a safe and effective procedure with low morbimortality. Minimally invasive video-assisted cardiac surgery is already a reality in Brazil, demonstrating excellent aesthetic and functional results. Descriptors: Minimally invasive surgical procedures, methods. Video assisted thoracic surgery. Heart valves, surgery. Congenital Heart defects, surgery. Atrial fibrillation/therapy.
Databáze: OpenAIRE