Submit to JCM Review for JCM Propose a Special Issue

Journal Menu

Journal Browser

Minimally Invasive Heart Surgery

Print Special Issue Flyer
Special Issue Editors
Special Issue Information
Keywords
Benefits of Publishing in a Special Issue
Published Papers

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (20 October 2024) | Viewed by 11374

Share This Special Issue

Special Issue Editor

Dr. Manuel Wilbring

E-Mail Website
Guest Editor

Department of Cardiac Surgery, University Heart Center, Dresden, Germany
Interests: minimally invasive cardiac surgery; aortic surgery; LVAD surgery

Special Issue Information

Dear Colleagues,

We are experiencing an era of remarkable development in cardiac surgery, with TAVI setting the ball rolling around 20 years ago. Some might see the development over the past decade as a rivalry or a threat, but others might see it as an opportunity.

This external (percutaneous) pressure has translated into a profound change in everyday cardiac surgery.

Let us take aortic valve surgery as an example. Cosgrove and Rao published papers on minimally invasive procedures in the early 1990s, but there was little further development in the following 20 years because it was not required. In 2007, the year before the broader clinical implementation of TAVI, the proportion of minimally invasive aortic valve procedures was minor at less than 5%. It was only after TAVI’s use in aortic valve therapies began to increase that progress became necessary. The proportion of minimally invasive aortic valve surgeries was close to 40% in Germany in 2021. This emphasizes the potential of developments that have occurred in the last decade.

Today, there are many possibilities: risk-adjusted hybrid strategies; minimally invasive access routes for valve surgery; CABG, or even assisted surgery; less invasive cannulation and perfusion strategies; and patient-orientated individualized treatment concepts.

This Special Issue welcomes all innovative and future-orientated ideas, whether they are techniques, strategies or innovative conceptual approaches.

I am eager to receive your ideas for the advancement of future innovation.

Dr. Manuel Wilbring
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

minimally invasive
aortic valve
mitral valve
hybrid approaches
techniques
strategies

Benefits of Publishing in a Special Issue

Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
e-Book format: Special Issues with more than 10 articles can be published as dedicated e-books, ensuring wide and rapid dissemination.

Further information on MDPI's Special Issue polices can be found here.

Published Papers (10 papers)

Download All Papers

Order results

Result details

Show export options Show export options

Select all

Export citation of selected articles as:

Research

Jump to: Review

15 pages, 2310 KiB

Open AccessArticle

Minimally Invasive Aortic Valve Replacement for High-Risk Populations: Transaxillary Access Enhances Survival in Patients with Obesity

by Ali Taghizadeh-Waghefi, Asen Petrov, Sebastian Arzt, Konstantin Alexiou, Klaus Matschke, Utz Kappert and Manuel Wilbring

J. Clin. Med. 2024, 13(21), 6529; https://doi.org/10.3390/jcm13216529 - 30 Oct 2024

Viewed by 597

Abstract

Background/Objectives: Minimally invasive cardiac surgery is often avoided in patients with obesity due to exposure and surgical access concerns. Nonetheless, these patients have elevated periprocedural risks. Minimally invasive transaxillary aortic valve surgery offers a sternum-sparing “nearly no visible scar” alternative to the traditional full sternotomy. This study evaluated the clinical outcomes of patients with obesity compared to a propensity score-matched full sternotomy cohort. Methods: This retrospective cohort study included 1086 patients with obesity (body mass index [BMI] of >30 kg/m²) undergoing isolated aortic valve replacement from 2014 to 2023. Two hundred consecutive patients who received transaxillary minimally invasive cardiac lateral surgery (MICLAT-S) served as a treatment group, while a control group was generated via 1:1 propensity score matching from 886 patients who underwent full sternotomy. The final sample comprised 400 patients in both groups. Outcomes included major adverse cardio-cerebral events, mortality, and postoperative complications. Results: After matching, the clinical baselines were comparable. The mean BMI was 34.4 ± 4.0 kg/m² (median: 33.9, range: 31.0–64.0). Despite the significantly longer skin-to-skin time (135.0 ± 37.7 vs. 119.0 ± 33.8 min; p ≤ 0.001), cardiopulmonary bypass time (69.1 ± 19.1 vs. 56.1 ± 21.4 min; p ≤ 0.001), and aortic cross-clamp time (44.0 ± 13.4 vs. 41.9 ± 13.3 min; p = 0.044), the MICLAT-S group showed a shorter hospital stay (9.71 ± 6.19 vs. 12.4 ± 7.13 days; p ≤ 0.001), lower transfusion requirements (0.54 ± 1.67 vs. 5.17 ± 9.38 units; p ≤ 0.001), reduced postoperative wound healing issues (5.0% vs. 12.0%; p = 0.012), and a lower 30-day mortality rate (1.5% vs. 6.0%; p = 0.031). Conclusions: MICLAT-S is safe and effective. Compared to traditional sternotomy in patients with obesity, MICLAT-S improves survival, reduces postoperative morbidity, and shortens hospital stays. Full article

(This article belongs to the Special Issue Minimally Invasive Heart Surgery)

► Show Figures

Figure 1

14 pages, 850 KiB

Open AccessArticle

Can Obesity Serve as a Barrier to Minimally Invasive Mitral Valve Surgery? Overcoming the Limitations—A Multivariate Logistic Regression Analysis

by Sadeq Ali-Hasan-Al-Saegh, Florian Helms, Khalil Aburahma, Sho Takemoto, Nunzio Davide De Manna, Lukman Amanov, Fabio Ius, Jan Karsten, Alina Zubarevich, Bastian Schmack, Tim Kaufeld, Aron-Frederik Popov, Arjang Ruhparwar, Jawad Salman and Alexander Weymann

J. Clin. Med. 2024, 13(21), 6355; https://doi.org/10.3390/jcm13216355 - 24 Oct 2024

Viewed by 509

Abstract

Background/Objectives: Over the past two decades, significant advancements in mitral valve surgery have focused on minimally invasive techniques. Some surgeons consider obesity as a relative contraindication for minimally invasive mitral valve surgery (MIMVS). The aim of this study is to evaluate whether the specific characteristics of obese patients contribute to increased surgical complexity and whether this, in turn, leads to worse clinical outcomes compared to non-obese patients. Furthermore, we aim to explore whether these findings could substantiate the consideration of limiting this treatment option for obese patients. We investigated the outcomes of MIMVS in obese and non-obese patients at a high-volume center in Germany staffed by an experienced surgical team well-versed in perioperative management. Methods: A total of 934 MIMVS were performed in our high-volume center in Germany from 2011 to 2023. Of these, 196 patients had a BMI of 30 or higher (obese group), while 738 patients had a BMI below 30 (non-obese group), all of whom underwent MIMVS by right minithoracotomy. Demographic information, echocardiographic assessments, surgical data, and clinical outcome parameters were collected for all patients. Results: There was no significant difference in in-hospital, 30-day, and late mortality between groups (obese vs. non-obese: 6 [3.0%] vs. 14 [1.8%], p = 0.40; 6 [3.0%] vs. 14 [1.8%], p = 0.40; 13 [6.6%] vs. 39 [5.3%], p = 0.48, respectively). Respiratory insufficiency and arrhythmia occurred more frequently in the obese group (obese vs. non-obese: 25 [12.7%] vs. 35 [4.7%], p < 0.001; 35 [17.8%] vs. 77 [10.4%], p = 0.006). Conclusions: Obesity was not associated with increased early or late mortality in patients undergoing MIMVS. However, obese patients experienced higher incidences of postoperative complications, including respiratory insufficiency, arrhythmias, delirium, and wound dehiscence. Nonetheless, a multivariate logistic regression analysis indicated that obesity itself does not contraindicate MIMVS and should not be viewed as a barrier to offering this minimally invasive approach to obese patients. Full article

(This article belongs to the Special Issue Minimally Invasive Heart Surgery)

► Show Figures

Figure 1

10 pages, 225 KiB

Open AccessArticle

Hypothermic Ventricular Fibrillation in Redo Minimally Invasive Mitral Valve Surgery: A Promising Solution for a Surgical Challenge

by Jawad Salman, Maximilian Franz, Khalil Aburahma, Nunzio Davide de Manna, Saleh Tavil, Sadeq Ali-Hasan-Al-Saegh, Fabio Ius, Dietmar Boethig, Alina Zubarevich, Bastian Schmack, Tim Kaufeld, Aron-Frederik Popov, Arjang Ruhparwar and Alexander Weymann

J. Clin. Med. 2024, 13(14), 4269; https://doi.org/10.3390/jcm13144269 - 22 Jul 2024

Viewed by 1007

Abstract

Background: Minimally invasive mitral valve surgery (MIMVS) is a treatment for severe mitral valve pathologies. In redo cases, especially after coronary artery bypass grafting (CABG) surgery with patent mammary bypass grafts, establishing aortic clamping followed by antegrade cardioplegia application might be challenging. Here, we present the outcome of hypothermic ventricular fibrillation as an alternative to conventional cardioprotection. Methods: Patients who underwent MIMVS either received hypothermic ventricular fibrillation (study group, n = 48) or antegrade cardioprotection (control group, n = 840) and were observed for 30 postoperative days. Data were retrospectively analyzed and collected from January 2011 until December 2022. Results: Patients in the study group had a higher preoperative prevalence of renal insufficiency (p = 0.001), extracardiac arteriopathy (p = 0.001), insulin-dependent diabetes mellitus (p = 0.001) and chronic lung disease (p = 0.036). Furthermore, they had a longer surgery time and a lower repair rate (p < 0.001). No difference, however, was seen in postoperative incidences of stroke (p = 0.26), myocardial infarction (p = 1) and mitral valve re-operation (p = 1) as well as 30-day mortality (p = 0.1) and postoperative mitral valve insufficiency or stenosis. Conclusions: The patients who underwent redo MIMVS with hypothermic ventricular fibrillation did not have worse outcomes or more serious adverse events compared to the patients who received routine conventional cardioprotection. Therefore, the use of hypothermic ventricular fibrillation appears to be a promising cardioprotective technique in this challenging patient population requiring redo MIMVS. Full article

(This article belongs to the Special Issue Minimally Invasive Heart Surgery)

7 pages, 194 KiB

Open AccessArticle

Minimally Invasive Surgery through Right Mini-Thoracotomy for Mitral Valve Infective Endocarditis: Contraindicated or Safely Possible?

by Maximilian Franz, Khalil Aburahma, Fabio Ius, Sadeq Ali-Hasan-Al-Saegh, Dietmar Boethig, Nora Hertel, Alina Zubarevich, Tim Kaufeld, Arjang Ruhparwar, Alexander Weymann and Jawad Salman

J. Clin. Med. 2024, 13(14), 4182; https://doi.org/10.3390/jcm13144182 - 17 Jul 2024

Viewed by 859

Abstract

Background: Mitral valve infective endocarditis (IE) still has a high mortality. Minimally invasive mitral valve surgery (MIMVS) is technically more challenging, especially in patients with endocarditis. Here, we compare the early postoperative outcome of patients with endocarditis and other indications for MIMVS. Methods: Two groups were formed, one consisting of patients who underwent surgery because of mitral valve endocarditis (IE group: n = 75) and the other group consisting of patients who had another indication for MIMVS (non-IE group: n = 862). Patients were observed for 30 postoperative days. Data were retrospectively reviewed and collected from January 2011 to September 2023. Results: Patients from the IE group were younger (60 vs. 68 years; p < 0.001) and had a higher preoperative history of stroke (26% vs. 6%; p < 0.001) with neurological symptoms (26% vs. 9%; p < 0.001). No difference was seen in overall surgery time (211 vs. 206 min; p = 0.71), time on cardiopulmonary bypass (137 vs. 137 min; p = 0.42) and aortic clamping time (76 vs. 78 min; p = 0.42). Concerning postoperative data, the IE group had a higher requirement of erythrocyte transfusion (2 vs. 0; p = 0.041). But no difference was seen in the need for a mitral valve redo procedure, bleeding, postoperative stroke, cerebral bleeding, new-onset dialysis, overall intubation time, sepsis, pacemaker implantation, wound healing disorders and 30-day mortality. Conclusions: Minimally invasive mitral valve surgery in patients with mitral valve endocarditis is feasible and safe. Infective endocarditis should not be considered as a contraindication for MIMVS. Full article

(This article belongs to the Special Issue Minimally Invasive Heart Surgery)

10 pages, 496 KiB

Open AccessArticle

Minimally Invasive Direct Coronary Artery Bypass Grafting: Sixteen Years of Single-Center Experience

by Alexander Weymann, Lukman Amanov, Eleftherios Beltsios, Arian Arjomandi Rad, Marcin Szczechowicz, Ali Saad Merzah, Sadeq Ali-Hasan-Al-Saegh, Bastian Schmack, Issam Ismail, Aron-Frederik Popov, Arjang Ruhparwar and Alina Zubarevich

J. Clin. Med. 2024, 13(11), 3338; https://doi.org/10.3390/jcm13113338 - 5 Jun 2024

Viewed by 1030

Abstract

Background: Coronary artery disease is a major cause of death globally. Minimally invasive direct coronary artery bypass (MIDCAB), using a small left anterior thoracotomy, aims to provide a less invasive alternative to traditional procedures, potentially improving patient outcomes with reduced recovery times. Methods: This retrospective, non-randomized study analyzed 310 patients who underwent MIDCAB between July 1999 and April 2022. Data were collected on demographics, clinical characteristics, operative and postoperative outcomes, and follow-up mortality and morbidity. Statistical analysis was conducted using IBM SPSS, with survival curves generated via the Kaplan–Meier method. Results: The cohort had a mean age of 63.3 ± 10.9 years, with 30.6% females. The majority of surgeries were elective (76.1%), with an average operating time of 129.7 ± 35.3 min. The median rate of intraoperative blood transfusions was 0.0 (CI 0.0–2.0) Units. The mean in-hospital stay was 8.7 ± 5.5 days, and the median ICU stay was just one day. Early postoperative complications were minimal, with a 0.64% in-hospital mortality rate. The 6-month and 1-year mortalities were 0.97%, with a 10-year survival rate of 94.3%. There were two cases of perioperative myocardial infarction and no instances of stroke or new onset dialysis. Conclusions: The MIDCAB approach demonstrates significant benefits in terms of patient recovery and long-term outcomes, offering a viable and effective alternative for patients suitable for less invasive procedures. Our results suggest that MIDCAB is a safe option with favorable survival rates, justifying its consideration in high-volume centers focused on minimally invasive techniques. Full article

(This article belongs to the Special Issue Minimally Invasive Heart Surgery)

► Show Figures

Figure 1

8 pages, 553 KiB

Open AccessArticle

Minimally Invasive Approach for Replacement of the Ascending Aorta towards the Proximal Aortic Arch

by Florian Helms, Ezin Deniz, Heike Krüger, Alina Zubarevich, Jan Dieter Schmitto, Reza Poyanmehr, Martin Hinteregger, Andreas Martens, Alexander Weymann, Arjang Ruhparwar, Bastian Schmack and Aron-Frederik Popov

J. Clin. Med. 2024, 13(11), 3274; https://doi.org/10.3390/jcm13113274 - 31 May 2024

Viewed by 961

Abstract

Objectives: In recent years, minimally invasive approaches have been used with increasing frequency, even for more complex aortic procedures. However, evidence on the practicability and safety of expanding minimally invasive techniques from isolated operations of the ascending aorta towards more complex operations such as the hemiarch replacement is still scarce to date. Methods: A total of 86 patients undergoing elective surgical replacement of the ascending aorta with (n = 40) or without (n = 46) concomitant proximal aortic arch replacement between 2009 and 2023 were analyzed in a retrospective single-center analysis. Groups were compared regarding operation times, intra- and postoperative complications and long-term survival. Results: Operation times and ventilation times were significantly longer in the hemiarch replacement group. Despite this, no statistically significant differences between the two groups were observed for the duration of the ICU and hospital stay and postoperative complication rates. At ten-year follow-up, overall survival was 82.6% after isolated ascending aorta replacement and 86.3% after hemiarch replacement (p = 0.441). Conclusions: Expanding the indication for minimally invasive aortic surgery towards the proximal aortic arch resulted in comparable postoperative complication rates, length of hospital stay and overall long-term survival compared to the well-established minimally invasive isolated supracommissural ascending aorta replacement. Full article

(This article belongs to the Special Issue Minimally Invasive Heart Surgery)

► Show Figures

Figure 1

10 pages, 616 KiB

Open AccessArticle

Combined Minimally Invasive Mitral Valve Surgery and Percutaneous Coronary Intervention: A Hybrid Concept for Patients with Mitral Valve and Coronary Pathologies

by Martín Moscoso-Ludueña, Maximilian Vondran, Marc Irqsusi, Holger Nef, Ardawan J. Rastan and Tamer Ghazy

J. Clin. Med. 2023, 12(17), 5553; https://doi.org/10.3390/jcm12175553 - 26 Aug 2023

Viewed by 1042

Abstract

We evaluated the feasibility of hybrid percutaneous coronary intervention (PCI) and minimally invasive mitral valve surgery (MIMVS) in patients with concomitant coronary and mitral disease. Of 534 patients who underwent MIMVS at our institution between 2012 and 2018, those with combined mitral and single vessel coronary pathologies who underwent MIMVS and PCI were included. Patients were excluded if they had endocarditis or required emergency procedures. Preprocedural, procedural, and postprocedural data were retrospectively analyzed. In total, 10 patients (median age, 75 years; 7 males) with a median ejection fraction (EF) of 60% were included. Nine patients underwent PCI before and one after MIMVS. The success rate was 100% in both procedures. There were no postoperative myocardial infarctions or strokes. Two patients developed delirium and one required re-thoracotomy for bleeding. The median stay in intensive care and the hospital was 3 and 8 days, respectively. The 30-day survival rate was 100%. A hybrid PCI and MIMVS approach is feasible in patients with mitral valve and single vessel coronary disease. In combined pathologies, the revascularization strategy should be evaluated independent from the mitral valve pathology in the presence of MIMVS expertise. Extension of this recommendation to multivessel disease should be evaluated in future studies. Full article

(This article belongs to the Special Issue Minimally Invasive Heart Surgery)

► Show Figures

Graphical abstract

14 pages, 2643 KiB

Open AccessArticle

Minimally Invasive Isolated Aortic Valve Replacement in a Potential TAVI Cohort of Patients Aged ≥ 75 Years: A Propensity-Matched Analysis

by Ali Taghizadeh-Waghefi, Asen Petrov, Philipp Jatzke, Manuel Wilbring, Utz Kappert, Klaus Matschke, Konstantin Alexiou and Sebastian Arzt

J. Clin. Med. 2023, 12(15), 4963; https://doi.org/10.3390/jcm12154963 - 28 Jul 2023

Cited by 2 | Viewed by 1007

Abstract

(1) Background and Objectives: Transcatheter aortic valve implantation is guideline-recommended from the age of 75. However, this European guideline recommendation is based on limited evidence, since no interaction between age and primary outcome has been found in guideline-stated references. This study aimed to compare the short-term outcomes of minimally invasive isolated aortic valve replacement in patients aged ≥ 75 with those of younger patients; (2) Patients and Methods: This retrospective cohort study included 1339 patients who underwent minimally invasive isolated aortic valve replacement at our facility between 2014 and 2022. This cohort was divided into two age-based groups: <75 and ≥75 years. Operative morbidity and mortality were compared between groups. Further analysis was performed using propensity score matching; (3) Results: After matching, 347 pairs of patients were included and analyzed. Despite the higher EuroSCORE II in the ≥75 group (2.2 ± 1.3% vs. 1.80 ± 1.34%, p ≤ 0.001), the 30-day mortality (1.4% vs. 1.2%; p = 0.90) and major adverse cardiac and cerebrovascular events, such as perioperative myocardial infarction (0.0% vs. 1.2%, p = 0.12) and stroke (1.4% vs. 2.6%, p = 0.06), were comparable between both treatment groups; (4) Conclusions: Minimally invasive aortic valve replacement is a safe treatment method for patients aged ≥ 75. Our results indicate that the unilateral cut-off of 75 years is not a limiting factor for performing minimally invasive aortic valve replacement. Full article

(This article belongs to the Special Issue Minimally Invasive Heart Surgery)

► Show Figures

Figure 1

14 pages, 6835 KiB

Open AccessArticle

Patient-Centred Outcomes after Totally Endoscopic Cardiac Surgery: One-Year Follow-Up

by Jade Claessens, Pieter Goris, Alaaddin Yilmaz, Silke Van Genechten, Marithé Claes, Loren Packlé, Maud Pierson, Jeroen Vandenbrande, Abdullah Kaya and Björn Stessel

J. Clin. Med. 2023, 12(13), 4406; https://doi.org/10.3390/jcm12134406 - 30 Jun 2023

Cited by 1 | Viewed by 1400

Abstract

Patient-centred outcomes have grown in popularity over recent years in surgical care research. These patient-centred outcomes can be measured through the health-related quality of life (HRQL) without professional interpretations. In May 2022, a study regarding patient-centred outcomes up to 90 days postoperatively was published. Fourteen days after surgery, the HRQL decreased and returned to baseline levels after 30 days. Next, the HRQL significantly improved 90 days postoperatively. However, this study only focuses on a short-term follow-up of the patients. Hence, this follow-up study aims to assess the HRQL one year after totally endoscopic cardiac surgery. At baseline, 14, 30, and 90 days, and one year after surgery, the HRQL was evaluated using a 36-item short form and 5-dimensional European QoL questionnaires (EQ-5D). Using the 36-item short form questionnaire, a physical and mental component score is calculated. Over the period of one year, this physical and mental component score and the EQ-5D index value significantly improve. According to the visual analogue scale of the EQ-5D, patients score their health significantly higher one year postoperatively. In conclusion, after endoscopic cardiac surgery, the HRQL is significantly improved 90 days postoperatively and remains high one year afterward. Full article

(This article belongs to the Special Issue Minimally Invasive Heart Surgery)

► Show Figures

Figure 1

Review

Jump to: Research

12 pages, 13016 KiB

Open AccessReview

Anesthesia for Minimal Invasive Cardiac Surgery: The Bonn Heart Center Protocol

by Florian Piekarski, Marc Rohner, Nadejda Monsefi, Farhad Bakhtiary and Markus Velten

J. Clin. Med. 2024, 13(13), 3939; https://doi.org/10.3390/jcm13133939 - 5 Jul 2024

Viewed by 2039

Abstract

The development and adoption of minimally invasive techniques has revolutionized various surgical disciplines and has also been introduced into cardiac surgery, offering patients less invasive options with reduced trauma and faster recovery time compared to traditional open-heart procedures with sternotomy. This article provides a comprehensive overview of the anesthesiologic management for minimally invasive cardiac surgery (MICS), focusing on preoperative assessment, intraoperative anesthesia techniques, and postoperative care protocols. Anesthesia induction and airway management strategies are tailored to each patient’s needs, with meticulous attention to maintaining hemodynamic stability and ensuring adequate ventilation. Intraoperative monitoring, including transesophageal echocardiography (TEE), processed EEG monitoring, and near-infrared spectroscopy (NIRS), facilitates real-time assessment of cardiac and cerebral perfusion, as well as function, optimizing patient safety and improving outcomes. The peripheral cannulation techniques for cardiopulmonary bypass (CPB) initiation are described, highlighting the importance of cannula placement to minimize tissue as well as vessel trauma and optimize perfusion. This article also discusses specific MICS procedures, detailing anesthetic considerations and surgical techniques. The perioperative care of patients undergoing MICS requires a multidisciplinary approach including surgeons, perfusionists, and anesthesiologists adhering to standardized treatment protocols and pathways. By leveraging advanced monitoring techniques and tailored anesthetic protocols, clinicians can optimize patient outcomes and promote early extubation and enhanced recovery. Full article

(This article belongs to the Special Issue Minimally Invasive Heart Surgery)

► Show Figures

Journal Menu

Journal Browser

Minimally Invasive Heart Surgery

Share This Special Issue

Special Issue Editor

Special Issue Information

Keywords

Benefits of Publishing in a Special Issue

Published Papers (10 papers)

Research

Review

Further Information

Guidelines

MDPI Initiatives

Follow MDPI