초록접수 현황
| 20F-151 | 구연 발표 |
Outcomes of minimally invasive approach during Hemi-arch or Total-arch replacement surgery
Shia kim, Ho jin Kim, Joon bum Kim
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
Purpose : Minimal-access cardiac surgery, such as upper hemi-sternotomy or mini-thoracotomy, are currently accepted approach, associated with various advantages despite technically challanging. However, it remains controversial with little supporting evidence whether minimally invasive technique during arch surgery is feasible and efficacious. This study describes the operative profiles of hemi-arch or total-arch replacement with minimally invasive approach and evaluates early and overall clinical outcomes.
Methods : We retrospectively reviewed records of consecutive 59 patients with Total arch or Hemi-arch replacement via minimally invasive approach undergoing at a single medical center from August 2015 to April 2020. All operations were performed by a single surgeon.
Results : Overall 59 patients (female 15) with a mean age of 58.2 ± 13.2 years underwent Hemiarch replacement and 70.9 ± 6.4 years underwent Total arch replacement. Conversion to full sternotomy was not needed. New acute renal failure occurred in 1 (2.2%), temporary neurologic deficit in 2 (4.4%) patients. Early mortality was observed in 1 (2.2%) patients.
Conclusion : Minimally invasive arch replacement surgery is challenging, but technically feasible, and this miniaturizing approach requires a proper training and should be done by expert surgeons. Excellent early outcomes were presented regardless of the type of arch replacement in this cohort. At this time, we cannot predict the long-term outcome. But this less-invasive approaches by expert surgeons may increase the patients’ satisfaction, reduce the risks, thereby improve the postoperative outcomes.
Methods : We retrospectively reviewed records of consecutive 59 patients with Total arch or Hemi-arch replacement via minimally invasive approach undergoing at a single medical center from August 2015 to April 2020. All operations were performed by a single surgeon.
Results : Overall 59 patients (female 15) with a mean age of 58.2 ± 13.2 years underwent Hemiarch replacement and 70.9 ± 6.4 years underwent Total arch replacement. Conversion to full sternotomy was not needed. New acute renal failure occurred in 1 (2.2%), temporary neurologic deficit in 2 (4.4%) patients. Early mortality was observed in 1 (2.2%) patients.
Conclusion : Minimally invasive arch replacement surgery is challenging, but technically feasible, and this miniaturizing approach requires a proper training and should be done by expert surgeons. Excellent early outcomes were presented regardless of the type of arch replacement in this cohort. At this time, we cannot predict the long-term outcome. But this less-invasive approaches by expert surgeons may increase the patients’ satisfaction, reduce the risks, thereby improve the postoperative outcomes.
책임저자: Joon bum kim
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
발표자: Shia kim , E-mail : shiakim@naver.com