Early Clinical Outcomes of Minimally Invasive Cardiac Surgery: A 10-Year Experience

Objective: To evaluate the early clinical outcome of Minimally Invasive Cardiac Surgery (MICS) - A 10-year experience. Study Design: Analytical Cross-sectional study. Place and Duration of Study: Adult Cardiac Surgery Unit, Armed Forces Institute of Cardiology/National Institute of Heart Diseases (AFIC/NIHD), from Jan 1, 2014 to Dec 31, 2023. Methodology: One hundred and fifty six consecutive patients with isolated aortic valve, mitral valve or tricuspid valve disease and atrial septal defect underwent elective MICS. Operations involving the right and or left atrium were done by right mini-thoracotomy while those of aorta were done by partial mini-sternotomy. Isolated Minimally Invasive Direct Coronary Artery Bypass (MIDCAB) was done via left minithoracotomy. Post-operative complications and 30-day post-op mortality were recorded as early clinical outcomes. Results: Out of 156 patients, 92(59.0%) were males and 64(41.0%) were females. Median age of the study population was 36(29-48) years. Median ejection fraction was 60(50-60)%. Mean aortic cross-clamp time was 96.72±34.28 min, and median cardiopulmonary bypass (CPB) time was 146(121-176.25) min. Three most common procedures carried out in the series were MVR 59(37.8%), AVR 55(35.3%) and ASD closure 22(14.1%). The total rate of complication was 7.7%, and mortality within 30 days was 3(1.9%). A significant association was found between inotropic duration, ICU stay, ventilation time, and complications such as renal and respiratory failure, with mortality (p<0.05). Conclusion: As per our experience, different cardiac procedures can be performed via minimally invasive approaches with acceptable and reproducible outcome.