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Title: Comparison of the safety and efficacy between minimally invasive cardiac surgery and median sternotomy in a low-risk mixed Asian population in Singapore.
Authors: Ong, Zhi Xian
Wu, Duoduo
Luo, Haidong
Chang, Guohao
Sule, Jai Ajitchandra
Hu, Peggy
Kofidis, Theo
Keywords: cardiac surgery
heart surgery
minimally invasive surgery
open heart surgery
Issue Date: 4-Oct-2021
Publisher: Singapore Medical Journal
Citation: Ong, Zhi Xian, Wu, Duoduo, Luo, Haidong, Chang, Guohao, MD FAIZUS SAZZAD, Sule, Jai Ajitchandra, Hu, Peggy, Kofidis, Theo (2021-10-04). Comparison of the safety and efficacy between minimally invasive cardiac surgery and median sternotomy in a low-risk mixed Asian population in Singapore.. Singapore Med J. ScholarBank@NUS Repository.
Abstract: INTRODUCTION: Minimally invasive cardiac surgery (MICS) has attracted increasing attention, with institutions increasingly adopting this approach over conventional median sternotomy (MS). This study aimed to describe the outcomes of minimally invasive cardiac surgery in our institution as the only centre with an established MICS programme in Singapore. METHODS: Patients who had undergone cardiac procedures such as heart valve replacement or repair, coronary artery bypass grafting or atrial septal defect repair were included in the study. We analysed 4063 patients who had undergone MS and 390 patients who had undergone MICS between January 2009 and February 2020. RESULTS: Over the years, the number of MICS procedures performed increased, along with an increase in MICS operations with two or more concomitant cardiac procedures and a decrease in postoperative length of stay. Compared with patients who underwent MS, those who underwent MICS had shorter length of postoperative hospital stay (p < 0.001). On multivariate analysis, patients who underwent MICS had lower rates of atrial fibrillation (p = 0.021), reoperation (p = 0.028) and prolonged ventilation (p < 0.001). However, the rates of other postoperative complications were comparable between patients who underwent MICS and those who underwent MS. CONCLUSION: In our institution, MICS is a safe, reproducible and efficacious technique that yields superior outcomes compared with conventional MS procedures, in some aspects. The results of this study provide further evidence and support towards adopting the minimally invasive approach to cardiac surgery in a carefully selected group of cardiac patients in Singapore.
Source Title: Singapore Med J
ISSN: 0037-5675
DOI: 10.11622/smedj.2021136
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