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Abstract for Oral Presentation
Title: Combination of Port-Access and Direct Vision in Open Heart Surgery. Initial
Three Years Single Center Experience.
Azamat Kurmalayev, Ermagambet Kuatbayev, Darkhan Suigenbayev, Myrzabek
Mahmutov, Gaukhar Amreeva, Zhanibek Ashirov, Shaimyrat Tulegenov,
Lyazzyat Abikeeva
National Research Center for Cardiac Surgery, Astana, Kazakhstan.
Objective: The objective of this prospective cohort observational study was to assess
in-hospital mortality, bypass time and morbidity in all patients undergoing open heart
surgery at our Center using a combination of port access and direct vision.
Methods: Between January 2013 and September 2015 164 patients (69% female)
underwent open heart surgery using above-mentioned technique. Average age was 42
years (range: 18-72 years). Mean New York Heart Association functional class
2.18±0.8. Mean ejection fraction was 48±11. 109 (67%) patients had pulmonary
hypertension >30 mmHg. Atrial septal defect repair was in 64 (39%) patients, mitral
valve replacement in 37 (23%), mitral valve repair in 43 (26%), ventricular septal defect
repair in 3 (2%), tricuspid valve replacement in 10 (6%), aortic valve replacement in 3
(2%), pericaridium fenestration and draining in 2 (1%), tricuspid valve repair in 2 (1%).
In 3 cases of mitral valve surgery left atrium monopolar radiofrequency ablation was
performed.
Results:
There were no inhospital deaths. The mean cardiopulmonary bypass and aortic clamping
times were 135±15 minutes and 66±5 minutes, respectively. Mild pain at surgical access
site was reported in 15 patients (9%). Rethoracotomy for bleeding from intercostal
artery was required in one case. One patient had ischemic stroke in hospital. Conversion
to sternotomy was required in 4 patients because of adhesive pericarditis. Mean time to
discharge was 5±1 days.
Conclusions:
Minimally invasive access without sternotomy has been associated with good patient
outcomes at our Center. Post-operative recovery time was good, surgical site pain was
mild if reported, and there were low rates of conversion to conventional sternotomy.
Further research should focus on the procedure effectiveness compared to conventional
surgery and include longer follow-up.