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Cardiothoracic and Vascular Anesthesia
Anesthesia and Pain Medicine 2009;4(2):91-99.
Published online April 30, 2009.
Minimally invasive cardiac surgery
Sangmin Maria Lee
Department of Anesthesiology and Pain Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea. marialee@skku.edu
Abstract
The term minimally invasive cardiac surgery encompasses a number of different techniques, from minimally invasive direct coronary artery bypass grafting without the use of cardiopulmonary bypass to telemanipulation and computer-enhanced robot-directed surgery. The hoped-for benefits from minimally invasive surgery are less pain, less disfiguring, fewer blood transfusions, earlier return to activity, and lower cost. The technology involved in reducing surgical trauma and limiting the physiologic trespass of cardiac surgery on the patients concerns not only surgical instrumentation but also anesthetic management. Anesthetic plan includes one lung isolation, careful monitoring of hemodynamics and gas exchange, fast track technique, appropriate analgesia strategies, and the use of transesophageal echocardiography for evaluation of the heart and positioning of cannulae. A better understanding of these newer, unconventional surgical operations enables cardiac anesthesiologists to contribute to favorable outcomes.
Key Words: analgesia, anesthetic management, fast track technique, minimally invasive cardiac surgery, robot, transesophageal echocardiography
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