Experience in the application of minimally invasive heart surgery techniques in the conditions of the Federal Center for Cardiovascular Surgery

Objective. The disadvantages of sternotomic access to the heart include high traumatism, violation of the integrity of the chest frame The purpose of the study: to improve the effectiveness of treatment of cardiac surgery patients using minimally invasive technologies.

Research objectives:

1. To establish the effectiveness of the use of minimally invasive technologies in the treatment of cardiac pathology.
2. Reduce the risk of local and cardiopulmonary complications using minimally invasive technologies.

Materials and methods. During the period from 2016 to 2020, 1989 surgical treatments were performed in the CWC of the Federal Agricultural Research Center of Krasnoyarsk. Of these, 469 (23,4 %) operations were performed in patients with ischemic heart disease (CHD), 133 (6,6 %) operations were performed in patients with acquired mitral valve heart disease (PPS MK) and 245 (12 %) operations were performed in patients with acquired aortic valve disease (PPS AK). Also, during the five-year period, 364 (18 %) patients with valvular pathology in combination with atrial fibrillation were operated on. The group of patients who underwent a complete sternotomy included 140 patients, and the group in which the operation was performed through mini-access included 90 patients.

The results. On the part of the postoperative wound with a complete median sternotomy, five complications were observed in the form of a superficial and deep wound infection. While with minimally invasive access, such complications were not observed. The number of respiratory and heart failure, ONMC, AF in the postoperative period was significantly lower with mini-access. Bleeding in the postoperative period occurred in 5 patients with traditional access and in 2 patients with mini-access.

Conclusion. When using mini-access, we have an extremely low percentage of complications 19 versus 51, which certainly indicates that the use of minimally invasive approaches is a safe and effective way to improve the quality of treatment of patients, and also significantly reduces the risk of cardiopulmonary complications and complications from postoperative wounds.

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