Maximizing Minimally Invasive Cardiac Surgery With Enhanced Recovery (ERAS).

Rawn Salenger, Niv Ad, Michael C Grant, Faisal Bakaeen, Husam H Balkhy, Stephanie L Mick, Peyman Sardari Nia, Jörg Kempfert, Nikolaos Bonaros, Vinayak Bapat, Moritz C Wyler von Ballmoos, Marc Gerdisch, Douglas R Johnston, Daniel T Engelman
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Abstract

We convened a group of cardiac surgeons, intensivists, and anesthesiologists with extensive experience in minimally invasive cardiac surgery (MICS) and perioperative care to identify the essential elements of a MICS program and the relationship with Enhanced Recovery After Surgery (ERAS). The MICS incision should minimize tissue invasion without compromising surgical goals. MICS also requires safe management of hemodynamics and preservation of cardiac function, which we have termed myocardial management. Finally, comprehensive perioperative care through an ERAS program should be provided to allow patients to achieve optimal recovery. Therefore, we propose that MICS requires 3 elements: (1) a less invasive surgical incision (non-full sternotomy), (2) optimized myocardial management, and (3) ERAS. We contend that the full benefit of MICS can be achieved only by also utilizing an ERAS platform.

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最大限度地提高微创心脏手术的康复效果(ERAS)。
我们召集了一批在微创心脏手术 (MICS) 和围手术期护理方面具有丰富经验的心脏外科医生、重症监护医生和麻醉医生,以确定微创心脏手术 (MICS) 计划的基本要素以及与 "术后强化恢复"(ERAS) 的关系。MICS 切口应在不影响手术目标的前提下尽量减少组织侵犯。MICS 还要求安全管理血液动力学和保护心脏功能,我们称之为心肌管理。最后,应通过 ERAS 计划提供全面的围手术期护理,使患者获得最佳恢复。因此,我们提出 MICS 需要 3 个要素:(1)微创手术切口(非全胸骨切开术);(2)优化的心肌管理;(3)ERAS。我们认为,只有同时利用 ERAS 平台,才能充分发挥 MICS 的优势。
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来源期刊
CiteScore
2.00
自引率
6.70%
发文量
80
期刊介绍: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery is the first journal whose main mission is to disseminate information specifically about advances in technology and techniques that lead to less invasive treatment of cardiothoracic and vascular disease. It delivers cutting edge original research, reviews, essays, case reports, and editorials from the pioneers and experts in the field of minimally invasive cardiothoracic and vascular disease, including biomedical engineers. Also included are papers presented at the annual ISMICS meeting. Official Journal of the International Society for Minimally Invasive Cardiothoracic Surgery
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