scholarly journals Anesthetic Challenges in Minimally Invasive Cardiac Surgery

2019 ◽  
Vol 03 (01) ◽  
pp. 28-35
Author(s):  
Uma Balasubramanyam ◽  
Poonam Malhotra Kapoor
Keyword(s):  
New York ◽  
Cardiac Surgery ◽  
Minimally Invasive ◽  
Perioperative Management ◽  
Lung Ventilation ◽  
Minimally Invasive Cardiac Surgery ◽  
Cardiac Anesthesia ◽  
One Lung Ventilation ◽  
Optimal Outcomes ◽  
Thoracic Anesthesia

AbstractThe transition of cardiac surgery away from the traditional sternotomy approach toward more minimally invasive strategies continues to evolve over time. The first minimally invasive cardiac surgery was performed in 2005 in New York by a team led by Dr. Joseph T. McGinn. Anesthesiologists play in a key role in facilitating optimal outcomes in such procedures. Perioperative management of these patients poses specific challenges to the anesthesia team. The anesthesiologist must be skilled in numerous subspecialty skillsets including regional anesthesia and analgesia techniques, and elements of thoracic anesthesia practice, in particular one-lung ventilation (OLV), cardiac anesthesia, and transesophageal echocardiography.

scholarly journals Clinical application of ultrafast channel cardiac anesthesia assisted by serratus anterior plane block in right-thoracoscopic minimally invasive cardiac surgery: a retrospective cohort study

2022 ◽  
Author(s):  
Shenjie Jiang ◽  
Xiaokan Lou ◽  
Meijuan Yan
Keyword(s):  
Cardiac Surgery ◽  
Minimally Invasive ◽  
Clinical Application ◽  
Fast Track ◽  
Minimally Invasive Cardiac Surgery ◽  
Cardiac Anesthesia ◽  
Opioid Use ◽  
Serratus Anterior ◽  
Extubation Time ◽  
Anterior Plane

Objectives: This study aimed to investigate the effects of ultrafast channel cardiac anesthesia assisted by serratus anterior plane block on the post-operative rehabilitation of patients undergoing right-sided thoracoscopic minimally invasive cardiac surgery, as well as the safety and feasibility of the clinical application of this technique. Background: Regional nerve block has previously been used in cardiac surgery to reduce intraoperative opioid use and promote anesthesia in fast-track and ultra-fast-track cardiac surgery. However, the clinical application of ultrafast cardiac anesthesia assisted by serratus anterior plane block (SAPB) in minimally invasive cardiac surgery under thoracoscopy has not been reported. Methods: A total of 102 patients who underwent right-sided thoracoscopic minimally invasive heart valve surgery in our center from January 2021 to August 2021 were enrolled and divided into two groups: an ultrafast channel cardiac anesthesia assisted by serratus anterior plane block (SAPB-GA) group (n=40) and a conventional general anesthesia (GA) group (n=62). The effects of ultrafast cardiac anesthesia assisted by serratus anterior plane block (SAPB) on post-operative rapid recovery as well as the safety and feasibility of its clinical application were compared and analyzed. Results: Compared to the GA group, the intraoperative use of sufentanil in the SAPB-GA group was significantly reduced (66.25±1.025, 283.31±11.362, P<0.001); the incidence of postoperative analgesia in ICU was significantly decreased (17%, 48.8%, P<0.001); the incidence of postoperative NRS≥3 in ICU was significantly decreased (15%, 37.1%, P = 0.016); and the postoperative extubation time (1(1-1), 13.84 (10.25-18.36), P<0.001), ICU stay time (28.58±2.838, 61.69±4.125, P<0.001) and postoperative hospital stay (8.08±0.313, 9.74±0.356, P=0.02) were significantly shortened; and the 24 h postoperative thoracic blood drainage was significantly reduced (209.63±25.645, 318.23±20.713, P<0.001). No statistical difference was observed in the incidence of postoperative nausea, vomiting and atelectasis between the two groups (all P>0.05). Both of the groups reported no postoperative cardiovascular events. Conclusions: Ultrafast channel cardiac anesthesia assisted by SAPB could promote the rapid postoperative recovery of patients undergoing minimally invasive cardiac surgery under a thoracoscope. This approach is safe and feasible in the clinic.

Minimally Invasive Cardiac Surgery Using a Flexible Aortic Clamp

2007 ◽  
Vol 10 (6) ◽  
pp. E428-E430
Author(s):  
B. Reddy Dandolu ◽  
John L. Parmet ◽  
Charles Yarnall ◽  
Alice Isidro ◽  
Charles R. Bridges
Keyword(s):  
Cardiac Surgery ◽  
Minimally Invasive ◽  
Minimally Invasive Cardiac Surgery

The “Spacemaker”, a New Device for Minimally Invasive Cardiothoracic Surgery: An Evaluation and Feasibility Study

2015 ◽  
Vol 10 (4) ◽  
pp. 241-247
Author(s):  
Pieter W.J. Lozekoot ◽  
Sandro Gelsomino ◽  
Paul B. Kwant ◽  
Orlando Parise ◽  
Francesco Matteucci ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Surgical Procedures ◽  
Lung Tissue ◽  
Lung Ventilation ◽  
Cardiothoracic Surgery ◽  
Respiratory Compromise ◽  
One Lung Ventilation ◽  
New Device ◽  
Lead Placement ◽  
The Right

Objective Our aim was to evaluate a new inflatable lung retractor, the “Spacemaker”, and its efficacy in facilitating minimally invasive cardiothoracic surgery without the need of one lung ventilation or carbon dioxide overpressure insufflation. Methods The device was tested in 12 anesthetized pigs (90–100 kg) placed on standard endotracheal ventilation. The device was introduced into the right or left side of the chest, depending on the intended procedure to be performed, via a 3-cm incision in the fifth intercostal space. A total of seven animals were used to evaluate hemodynamic and respiratory response to the device, whereas another five animals were used to assess the feasibility of a variety of minimally invasive cardiothoracic surgical procedures. Results Introduction was easy and unhindered. The device was inflated up to 0.6 bar, thereby pushing the lung tissue gently away cranially, posteriorly, and caudally without interfering with pulmonary function or resulting in respiratory compromise. In addition, hemodynamics remained stable throughout the experiments. Different closed-chest surgical procedures such as left atrial appendage exclusion, pulmonary vein exposure, pacemaker lead placement, and endoscopic stabilization for coronary surgery, were successfully performed. Removal was quick and complete in all cases, and lung tissue showed no remnant atelectasis. Conclusions The “Spacemaker” may represent a reliable alternative to current conventional techniques to facilitate minimally invasive cardiothoracic surgery. Further research is warranted to confirm the effectiveness and the safety of this device and to optimize the model before its use in humans and its introduction into clinical practice.

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