Outcomes of Minimally Invasive Cardiac Surgery

Cixin MM and Gapurovna AN

Published on: 2025-06-11

Abstract

Background: Minimally Invasive Cardiac Surgery (MICS) is increasingly favored over conventional approaches due to its potential for reduced morbidity and quicker recovery. This study evaluates the early outcomes of various MICS procedures including Minimally Invasive Coronary Artery Bypass Grafting (MICABG), Robotic-Assisted MICABG (RAMICABG), Minimally Invasive Mitral Valve Replacement/Repair (MIMVR/Repair), and Minimally Invasive Aortic Valve Replacement (MIAVR).

Methods: A retrospective analysis was conducted on 386 patients who underwent MICS. The procedures included MICABG (46.1%), RAMICABG (32.1%), MIMVR (8%), MIMV Repair (2.1%), and MIAVR (6.7%). Additional miscellaneous minimally invasive procedures accounted for 4.9% of cases. Early outcomes assessed included 30-day/in-hospital mortality, ventilation hours, ICU stay, and total hospital stay.

Results: Overall 30-day mortality was 1.8% (7 patients), with rates of 3.22% for MICABG, 1.1% for RAMICABG, and 3.8% for MIAVR. No mortality was observed in MIMVR/Repair. The average number of grafts used was 2.2±1.03. Conversion to sternotomy occurred in 2.8% of cases, primarily due to hemodynamic instability or surgical complications. Cardiopulmonary bypass was used in 18.1% of cases, with mean bypass and cross-clamp times of 168.67 ± 62.39 and 123.91 ± 47.37 minutes, respectively. Mean ventilation time was 10.92 ± 7.83 hours, ICU stay was 2.80 ± 1.23 days, and total hospital stay was 4.54 ± 3.03 days.

Conclusions: MICS demonstrates favorable early outcomes with low mortality and shorter hospital stays when compared to conventional cardiac surgery. While certain subgroups had slightly higher mortality rates than reported in some studies, these were still generally lower than those associated with traditional open procedures. Conversion and complication rates remained acceptably low, supporting the continued use and advancement of minimally invasive cardiac techniques.