It is possible to perform surgery without stopping the heart and through a small incision to open blockages in the coronary artery, which is the left anterior descending branch that feeds the anterior wall of the heart, called LAD. The purpose of performing surgery without stopping the heart and through a small incision is to protect patients from certain complications. This article is a Turkish summary of a scientific article, with the aim of informing patients about preventive treatments.
For long years heart surgerySurgeries have been performed using the extracorporeal circulation, which we call the heart-lung machine. The surgery is performed by completely opening the anterior chest wall and stopping the heart, which is worrying for patients, prevents a quick return to daily life after surgery, and the large size of the scar may be cosmetically disturbing for the patient.
In order to prevent these negative results and at the same time provide effective treatment, in recent years, it has been possible to treat suitable patients without stopping the heart. “in the working heart” and through a small incision of 4-5 cm bypass surgeries It is possible to perform surgery through a small incision without stopping the heart to open blockages in the coronary artery, which we call the LAD, which is the left anterior descending branch that feeds the front wall of the heart.
Compared to surgeries performed with the classical method, it has significant advantages for the patient. These are; shorter hospital stay, less pain, quicker mobilization, quicker return to daily life and smaller cosmetic scars. Our study on 197 patients supports this information. According to our study, minimally invasive (small incision), bypass surgery In patients who underwent surgery, the surgery lasted an average of 90 minutes with a 5 cm midline incision and the patients were transferred from the intensive care unit to the ward approximately 6-14 hours after the surgery. They were discharged after an average of 4.5 days of hospitalization.
These patients had less pain relief during their hospital stays compared to patients who underwent surgery using the classical method. Since their pain levels were lower, they were able to mobilize earlier. Accordingly, according to the results of the surveys we conducted according to certain scales in the 1-month follow-ups, they were able to perform their daily life activities in a shorter time than patients who underwent surgery using the classical method. As a result of the 2-year follow-up, only 7 patients had occlusion in the graft vessel and only 1 patient required re-surgery. In our control group, which we call “median sternotomy”, patients who underwent surgery using the classical method, the pain relief requirements during their hospital stays were as follows: minimally invasive (small incision) According to the questionnaires conducted at the first month controls after the surgery, the return to daily living activities was delayed.
As a result of our study, in suitable patients, bypass surgery performed with a small incision on the beating heart has been found to be more advantageous than the classical method in terms of postoperative pain, mobilization, shorter hospital stay and return to daily life. When these two methods are compared, since there is no difference in the effectiveness of long-term treatment after surgery, minimally invasive bypass surgery can be safely preferred in suitable patients.
Anatolian Journal of Cardiology 2014:14: 172-7
