Abstracts Of The Cardiothoracic Section 13th Inter Annual Scientific Congress, RACS
Heart J 1999;8(1)
Abstracts Of The Cardiothoracic Section 13th Inter Annual Scientific Congress Royal Australasian College of Surgeons Surfers Paradise, Queensland 8111,111 0 5-8 November 1998
Minimally Invasive Cardiac Surgery Via Hemisternotomy R. Tam, A. Almeida The Prince Charles Hospital, Brisbane, Queensland removal of infected pacing wires. There were 2 operative deaths (2.8%). There was no wound dehiscence. Postoperative pain, as assessedby visual analogue scores, was significantly less compared to contemporaneous controls. Conclusion: Minimally invasive cardiac surgery can be performed safely with the benefits of less surgical trauma, less pain, improved cosmesis, and a potentially shorter ICU and hospital stay.
Background: To report the results of minimally invasive cardiac surgery via partial sternotomy. Results: 69 consecutive patients undergoing valve and intracardiac surgery via hemistemotomy were analysed. Mean age was 58.6 years (range, 29-84). Initially 25 patients underwent aortic valve replacement: 10 mitral valve repair, 13 mitral valve replacement, 3 combined aortic and mitral valve replacement, 2 atria1 myxoma, and 1
Transmyocardial Laser Revascularisation Using CO2 Laser M.S. Bayfield, S.M. Herman, R. Jeremy, C.F. Hughes Royal Prince Alfred Hospital, Sydney, New South Wales Background: In December 1996 we commenced a pilot program using CO2 laser for transmyocardial laser revascularisation in patients with CCVS grade 3-4 angina deemed unsuitable for conventional therapy with angioplasty or CABG. Methods: All patients were on maximal medical therapy. We have treated 40 patients with TMLR, all of whom have reached a minimum follow-up of 3 months. Results: Perioperative mortality was 5%; there have been no deaths in the past 34
consecutive cases. Perioperative morbidity has been low. 75% of patients have achieved a successful response to TMLR with reduction of CCVS anginal status by at least 2 classes. Conclusions: Our results agree with results from U.S. trials with diminished angina1 status, a reduction in hospital admissions for angina, and improved quality of life. TMLR is an effective tool for management of refractory severe angina in highly selected patients.
Complex Primary Aortic Arch Reconstruction P. Brady, D. Fernando Royal North Shore Hospital, Sydney, New South Wales Complex primary aortic arch Background: reconstruction was undertaken in 16 patients from October 1995 to September 1998. Methods: This series excluded patients who underwent hemi-arch or “open distal” procedures for aortic pathology. indications for arch reconstruction were: acute dissection (5); chronic dissection (5); aneurysm (6). Results: Seven patients (44%) had undergone previous cardiac surgery. All patients had other procedures at the time of arch
reconstruction, including 9 Bentall procedures (56%). Cerebral protection was achieved with hypothermic arrest plus antegrade cerebral perfusion in all patients. Three patients died. There was 1 patient with a new neurological deficit; 8 patients required reoperation for bleeding. Conclusions: Complex arch reconstruction can be performed electively and urgently with acceptable morbidity and mortality. Bleeding due to coagulopathy remains a major postoperative problem.