Leff, J. D. and L. J. Enriquez (2012). “Robotic-assisted cardiac surgery.” International Anesthesiology Clinics 50(2): 78-89.
Sündermann, S. H., J. Scherman, et al. (2012). “Minimally invasive and transcatheter techniques in high-risk cardiac surgery patients.” Interventional Cardiology 4(2): 253-263.
Minimally invasive procedures have become pivotal in cardiac surgery, especially for the ever-increasing group of high-risk patients. These procedures are defined by the surgical access and/or the avoidance of cardiopulmonary bypass. Both of these aspects have been shown to be beneficial for patients with an increased perioperative risk. For high-risk patients with coronary artery disease, off-pump coronary artery bypass surgery via various surgical access routes can be performed. For patients with heart valve disease, minimally invasive approaches are routinely used in the clinic. During the last decade, interventional methods to treat aortic and mitral valve disease including transcatheter aortic valve replacement and the MitraClip were developed. These modalities have provided clinicians with the ability to treat patients with very high operative risk that are considered not fit for conventional surgery. © 2012 Future Medicine Ltd.
Vernick, W. J. and J. Y. Woo (2012). “Anesthetic considerations during minimally invasive mitral valve surgery.” Seminars in Cardiothoracic and Vascular Anesthesia 16(1): 11-24.
Advances in instruments and visualization tools as well as circulatory systems for cardiopulmonary bypass during the late 1990s have stimulated widespread adoption of minimally invasive mitral valve surgery (MIMVS). Today, MIMVS is the standard approach for many surgeons and institutions. There are multiple benefits of MIMVS. Patient satisfaction and improved cosmesis are important. Additionally, studies have consistently shown faster recovery times and less associated pain with MIMVS. Statistically significant improvement in bleeding, transfusion, incidence of atrial fibrillation, and time to resumption of normal activities with MIMVS has also been shown when comparing MIMVS with conventional mitral surgery. Most important, these benefits have been achieved without sacrificing perioperative safety or durability of surgical repair. Although a steep learning curve still exists given the high level of case complexity, continued development fueled by increasing patient demand may allow for even further expansion in the use of minimal invasive techniques. © 2012 The Author(s).