Pontages coronariens par mini-thoracotomie: bénéfices visibles avec l'expérience croissante de l'équipe traitante [Coronary artery bypass by mini-thoracotomy: noticeable benefits with clinical experience of the treatment team]

Détails

ID Serval
serval:BIB_0E37252AFE81
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Pontages coronariens par mini-thoracotomie: bénéfices visibles avec l'expérience croissante de l'équipe traitante [Coronary artery bypass by mini-thoracotomy: noticeable benefits with clinical experience of the treatment team]
Périodique
Swiss Surgery
Auteur(s)
Tevaearai H.T., Mueller X.M., Chastonay P., Favre J.B., Ravussin P., Eckert P., Vogt P., Delabays A., von Segesser L., Stumpe F.
ISSN
0007-1323
Statut éditorial
Publié
Date de publication
2001
Volume
7
Numéro
1
Pages
16-19
Langue
français
Résumé
AIM OF THE STUDY: Minimally invasive coronary artery bypass surgery is fundamentally different as compared to open sternal approach under cardiopulmonary bypass. Modifications of the surgical, anesthesiologic and post-operative techniques are necessary before evaluation of its real benefit. We analyze the potential effect of a learning period on the short term results of this technique. METHODS: From July 1997 to February 1999, 20 patients were operated using this method. We compare the results of the first 10 patients (group 1: 8M/2F, 59.6 +/- 13.8 years) to those of the last 10 patients (group 2: 8M/2F; age = 63.2 +/- 6.1 years). DISCUSSION: Progress between the two groups is striking. Left anterior descending coronary clamping time could be reduced from 28.5 +/- 2.4 min. in group 1 to 22.2 +/- 1.8 min. in group 2 (p < 0.05), and operative time was reduced from 125 +/- 4 min. to 97 +/- 5 min. (p < 0.005). The post-operative atrial fibrillation rate diminished from 4/10 in group 1 to 1/10 in group 2.3/10 patients in group 1 suffered a post-operative pneumonia whereas none in group 2 had pulmonary complication. The stay in the intensive care unit could be reduced from 2.3 +/- 0.3 days to 1.4 +/- 0.2 days (p < 0.05) and the total post-operative stay diminished from 8.5 +/- 0.9 days to 4.7 +/- 0.5 days (p < 0.005). CONCLUSION: There are evidence for a learning period in minimally invasive cardiac surgery. Short term benefits of this technique are then evident as demonstrated by a reduction in the ICU stay and the hospital stay.
Mots-clé
Adult, Aged, Clinical Competence, Coronary Artery Bypass, Coronary Disease/surgery, Female, Humans, Male, Middle Aged, Postoperative Complications/etiology, Postoperative Complications/prevention &amp, control, Surgical Procedures, Minimally Invasive, Switzerland, Treatment Outcome
Pubmed
Création de la notice
28/01/2008 10:48
Dernière modification de la notice
20/08/2019 13:35
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