Minimally invasive cardiac surgery: A systematic review and meta-analysis

Title
Minimally invasive cardiac surgery: A systematic review and meta-analysis
Publication Date
2016
Author(s)
Dieberg, Gudrun
( author )
OrcID: https://orcid.org/0000-0001-7191-182X
Email: gdieberg@une.edu.au
UNE Id une-id:gdieberg
Smart, Neil
( author )
OrcID: https://orcid.org/0000-0002-8290-6409
Email: nsmart2@une.edu.au
UNE Id une-id:nsmart2
King, Nicola
Type of document
Journal Article
Language
en
Entity Type
Publication
Publisher
Elsevier Ireland Ltd
Place of publication
Ireland
DOI
10.1016/j.ijcard.2016.08.227
UNE publication id
une:19647
Abstract
'Background': Minimally invasive (MI) cardiac surgery was introduced to reduce problems associated with a full sternotomy. This meta-analysis aimed to investigate the effects of minimally invasive cardiac surgery on a range of clinical outcomes. 'Methods': To identify potential studies (randomised/prospective clinical trials) systematic searches were carried out. The search strategy included the concepts of "minimally invasive" OR "MIDCAB" AND "coronary artery bypass grafting" OR "cardiac surgery". This was followed by a meta-analysis investigating cross-clamp time, cardiopulmonary bypass (CPB) time, operation time, ventilation time, intensive care unit (ICU) stay, hospital stay, incidence of myocardial infarction and of stroke/neurologic complications. 'Results': Eight studies (9 intervention groups), totalling 596 participants were analysed. MI cardiac surgery was associated with a shorter ICU stay mean difference (MD) -0.7 days (95% confidence interval (CI) -1.23 to -0.18, p = 0.009) and longer cross-clamp MD 6.7 min (95% CI 1.24 to 12.17, p = 0.02), CPB MD 26.68 min (95% CI 10.31 to 43.05, p = 0.001), and operation times MD 55.03 min (95% CI 22.76 to 87.31, p = 0.0008). However no differences were found in the ventilation time MD−3.94 h (95% CI-8.09 to 0.21, p=0.06), length of hospital stay MD -1.14 days (95% CI -3.11 to 0.83, p = 0.26) and in the incidence of myocardial infarction odds ratio (OR) 1.97 (95% CI 0.49 to 7.9, p = 0.34) or stroke/neurologic complications OR 0.67 (95% CI 0.11 to 4.05, p = 0.66). 'Conclusions': Minimally invasive cardiac surgery is as safe as conventional surgery and could reduce costs due to a shorter period spent in ICU.
Link
Citation
International Journal of Cardiology, v.223, p. 554-560
ISSN
1874-1754
0167-5273
Start page
554
End page
560

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