Anesthetic management for minimally invasive cardiac surgery

Abstract

Minimally invasive cardiac surgery (MICS) has evolved as a less invasive alternative for conventional cardiac surgery that utilizes full median sternotomy. Currently employed procedures that utilize the minimally invasive approach encompass mitral valve surgery, aortic valve surgery, and less commonly coronary artery bypass and right atrial surgery. MICS has fulfilled its promise of fast-tracking and reducing some perioperative morbidities compared with conventional approaches. Adequate patient selection, surgical experience in the techniques, preparedness for conversion to full sternotomy, and, above all, adequate communication between surgeons and anesthesiologists are key to the safe conduct of MICS. Future studies should focus on comparing outcomes between MICS and the recently validated percutaneous valve surgery. Longer-term outcomes of both techniques are crucial for optimal patient selection of either technique.