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Anesthesia for minimally invasive cardiac surgery

Due to its potential benefits and increased patient satisfaction minimal invasive cardiac surgery (MICS) is rapidly gaining in popularity. These procedures are not without challenges and require careful planning, pre-operative patient assessment and excellent intraoperative communication. Assessment...

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Detalles Bibliográficos
Autores principales: White, Alexander, Patvardhan, Chinmay, Falter, Florian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8024802/
https://www.ncbi.nlm.nih.gov/pubmed/33841977
http://dx.doi.org/10.21037/jtd-20-1804
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author White, Alexander
Patvardhan, Chinmay
Falter, Florian
author_facet White, Alexander
Patvardhan, Chinmay
Falter, Florian
author_sort White, Alexander
collection PubMed
description Due to its potential benefits and increased patient satisfaction minimal invasive cardiac surgery (MICS) is rapidly gaining in popularity. These procedures are not without challenges and require careful planning, pre-operative patient assessment and excellent intraoperative communication. Assessment of patient suitability for MICS by a multi-disciplinary team during pre-operative workup is desirable. MICS requires additional skills that many might not consider to be part of the standard cardiac anesthetic toolkit. Anesthetists involved in MICS need not only be highly skilled in performing transesophageal echocardiography (TEE) but need to be proficient in multimodal analgesia, including locoregional or neuroaxial techniques. MICS procedures tend to cause more postoperative pain than standard median sternotomies do, and patients need analgesic management more in keeping with thoracic operations. Ultrasound guided peripheral regional anesthesia techniques like serratus anterior block can offer an advantage over neuroaxial techniques in patients on anti-platelet therapy or anticoagulation with low molecular weight or unfractionated heparin The article reviews the salient points pertaining to pre-operative assessment and suitability, intraoperative process and postoperative management of minimally invasive cardiac procedures in the operating theatre as well as the catheterization lab. Special emphasis is given to anesthetic management and analgesia techniques.
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spelling pubmed-80248022021-04-08 Anesthesia for minimally invasive cardiac surgery White, Alexander Patvardhan, Chinmay Falter, Florian J Thorac Dis Review Article on Minimally Invasive Cardiac Surgery Due to its potential benefits and increased patient satisfaction minimal invasive cardiac surgery (MICS) is rapidly gaining in popularity. These procedures are not without challenges and require careful planning, pre-operative patient assessment and excellent intraoperative communication. Assessment of patient suitability for MICS by a multi-disciplinary team during pre-operative workup is desirable. MICS requires additional skills that many might not consider to be part of the standard cardiac anesthetic toolkit. Anesthetists involved in MICS need not only be highly skilled in performing transesophageal echocardiography (TEE) but need to be proficient in multimodal analgesia, including locoregional or neuroaxial techniques. MICS procedures tend to cause more postoperative pain than standard median sternotomies do, and patients need analgesic management more in keeping with thoracic operations. Ultrasound guided peripheral regional anesthesia techniques like serratus anterior block can offer an advantage over neuroaxial techniques in patients on anti-platelet therapy or anticoagulation with low molecular weight or unfractionated heparin The article reviews the salient points pertaining to pre-operative assessment and suitability, intraoperative process and postoperative management of minimally invasive cardiac procedures in the operating theatre as well as the catheterization lab. Special emphasis is given to anesthetic management and analgesia techniques. AME Publishing Company 2021-03 /pmc/articles/PMC8024802/ /pubmed/33841977 http://dx.doi.org/10.21037/jtd-20-1804 Text en 2021 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Review Article on Minimally Invasive Cardiac Surgery
White, Alexander
Patvardhan, Chinmay
Falter, Florian
Anesthesia for minimally invasive cardiac surgery
title Anesthesia for minimally invasive cardiac surgery
title_full Anesthesia for minimally invasive cardiac surgery
title_fullStr Anesthesia for minimally invasive cardiac surgery
title_full_unstemmed Anesthesia for minimally invasive cardiac surgery
title_short Anesthesia for minimally invasive cardiac surgery
title_sort anesthesia for minimally invasive cardiac surgery
topic Review Article on Minimally Invasive Cardiac Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8024802/
https://www.ncbi.nlm.nih.gov/pubmed/33841977
http://dx.doi.org/10.21037/jtd-20-1804
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