VIDEO-ASSISTED CARDIAC-SURGERY - PRELIMINARY-RESULTS IN CHANG-GUNG-MEMORIAL-HOSPITAL

Objective To summarize the experience of utilization of video-assisted endoscopy in 91 patients operated on at Chang Gung Memorial Hospital, Taipei, China. Methods. From October 1995, through August 1996, 91 pa tients (44 male and 47 female) received video-assisted cardiac surgery (VACS). Their ages ranged from 1 year to 79.5 years (25.7 +/- 21.7). Indications for surgery were atrial septal defect (59 patients), ventr icular septal defect (15), coronary artery disease (4), severe mitral regurgitation (4), severe tricuspid regurgitation (3), thrombosis of m itral mechanical prosthesis (3), left atrial tumor (2), and left ventr icular thrombus with dilated cardiomyopathy (1). The VACS was performe d through right or left anterior minithoracotomy and guided by video-a ssisted endoscopic techniques by means of projected images on the vide o monitor under extracorporeal circulation. The aorta was not cross-cl amped and the myocardium was protected by continuous coronary perfusio n with hypothermic fibrillatory arrest (rectal temperature 22.6 +/- 4. 0 degrees C). Conventional instruments were used. Results. All lesions were corrected successfully. The bypass time was 27 to 335 minutes (7 2.8 +/- 52.7). The operative time was 1.3 to 8.5 hours (3.0 +/- 1.7). There were no operative deaths and 3 late deaths. Follow-up was comple te in all survivors (6 to 16 months, mean 8.7). Most of them were foun d to be in NYHA functional I or II. Conclusion. Our preliminary experi ences demonstrate that VACS is simple and effective in surgical correc tion of selected cardiac lesions. Short-term results show good outcome s.