Thoracoscope-assisted Right Vertical Infra-axillary Mini-incision for Cardiac Surgery

Background The thoracoscope and minimally invasive techniques have been effectively used in cardiac surgery. Methods The study included 27 consecutive patients (aged 24.8±17.6 years), who underwent cardiac surgery from January 2012 to July 2013. Six patients were diagnosed with mitral valve stenosis (MS), 17 patients with atrial septal defects (ADSs), and four with ventricular septal defects (VSDs). All the patients underwent thoracoscope-assisted right vertical infra-axillary mini-incision (TARVAI). Results The procedure was successfully performed in all patients. For the patients with ASDs or VSDs, the times for cardiopulmonary bypass, aortic cross-clamping, operating (skin-to-skin), ventilation, ICU stay, postoperative hospital stay were 63±25min, 28.1±15.5min, 167.1±35.7min, 5.2±2.7h, 25.3±10.5h, 8.7±3.6 days, and for the patients with MS, these were 143.3±25.2min, 88.2±15.4min, 236.5±48.5min, 7.3±1.5h, 36.7±9.1h, and 13.5±4.4 days, respectively. The median postoperative drainage (total) for the ASD/VSD and MS patients was 136.3±54.5ml and 203.8±94.4ml, respectively. Conclusions In our institution, the TARVAI approach is feasible and safe in cardiac surgery. It may be particularly useful in young patients with simple congenital heart disease and mitral valve disease.