Minimally Invasive Cardiac Surgery

Jae-Won Lee; Sung Ho Jung; Hyung Gon Je

doi:10.5124/jkma.2008.51.4.335

J Korean Med Assoc > Volume 51(4); 2008 > Article

Lee, Jung, and Je: Minimally Invasive Cardiac Surgery

Focused Issue of This Month

Heart Diseases in Adults

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2008; 51(4): 335-346.

Published online: April 30, 2008

DOI: http://dx.doi.org/10.5124/jkma.2008.51.4.335

Minimally Invasive Cardiac Surgery

Jae-Won Lee, MD, Sung Ho Jung, MD, Hyung Gon Je, MD

Department of Cardiovascular Surgery, University of Ulsan College of Medicine, Korea. jwlee@amc.seoul.kr

Abstract

Traditional cardiac surgery has been performed via a "big" median sternotomy incision by significant complexity and invasiveness. The traditional big incision has presented with many problems, and at the same time, has given opportunity to make the procedures less invasive. During the past decade, improvement in endoscopic equipments and operative techniques has resulted in development of minimal invasive cardiac operations using small incisions with or without robotics. A number of cardiac procedures are currently performed by minimal invasive approaches and for many surgeons a minimal invasive cardiac surgery has become a standard practice. Herein, we reviewed the minimal invasive cardiac surgery in the aortic valve, mitral valve, tricuspid valve, atrial septal defect, and coronary artery disease.

Minimal invasive; Robotic; Cardiac surgery

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Figure 1

The da Vinci™ surgical system.

Figure 2

A postoperative scar after minimally invasive mitral valve surgery.

Figure 3

Transapical aortic valve implantation via a limited left anterior thoracotomy.

Table 1

Potential benefits of minimally invasive mitral valve surgery

Table 2

Residual mitral regurgitation between sternotomy and minimally invasive surgery (MIS) patients

MR: mitral regurgitation, NS: not significant

Table 3

Mitral valve repair techniques

^*Q; quadrangular resection

^**T; triangular resection

MIS: minimally invasive surgery, NS: not significant

Table 4

Current Recommendations for OPCAB

OPCAB: Off-pump coronary artery bypass grafting, LAD: Left anterior descending coronary artery, RCA: Right coronary artery, LV: Left ventricle, LVEDP: Left ventricular end-diastolic pressure, MR: Mitral regurgitation, COPD: Chronic obstructive pulmonary disease

Table 5

Current Recommendations for MIDCAB

MIDCAB: Minimal invasive direct coronary artery bypass, LAD: Left anterior descending coronary artery, RCA: Right coronary artery, LIMA: Left internal mammary artery, LV: Left ventricle, LVEDP: Left ventricular end-diastolic pressure, OPCAB: Off-pump coronary artery bypass grafting, COPD; Chronic obstructive pulmonary disease