Abstract:
Introduction. Minimally invasive cardiac surgery has been gaining value in the Republic of Moldova since
2001, already occupying an exceptional place in both medical and teaching practice. It is an important
alternative in the treatment of congenital and acquired cardiac surgical pathologies that have a morbid
incidence in continuous growth.
Aim of study. Evaluation of the experience of the Cardiovascular Surgery Clinic,in approaching the
minimally invasive cardiac surgery treatment in terms of the possibilities and data of the contemporary
literature.
Methods and materials. The analysis includes 12 clinical cases, from the Cardiovascular Surgery
Clinic,aged between 2 months and 75 years (average 25.7 years),in the period 2001-2022,female sex 9
patients, male sex 3 patients, with body weight 12 kg and 70kg (average 41 kg),analyzing the clinical
appearance,diagnosis, intra-operative specificity and post-operative outcome.
Results. Patients who underwent cardiac surgery with a minimally invasive approach had different
diagnoses,requiring different surgical tactics, but in all 12 cases, using the approach by antero-lateral
thoracotomy of the IV intercostal space, on the right. In 6 cases it was performed. suturing the defect of the
interatrial septum, in 2 cases it was performed the plasty of the defect of the interatrial septum, with
autologous pericardial patch. A singular case is attested where: augmentation of the anterior cusp of the
tricuspid valve with autologous pericardial patch and implantation of the Medtronic Contour 3D ring
diameter 36; right atriotomy with excision of the aneurysm from which a patch was later used to close the
defect of the interatrial septum; mitral valve prosthesis with mechanical valve SJM-29, excision of the
myxoma (dimensions 21x11cm) in the region of the left atrium. The postoperative result is favourable, with
stopping sedation after 8 hours-14.5 hours (average 9.8 hours) post-operative, easy physical recovery, with
being in the profile section 3-5 days (average 3.8 days), post-operative with positive dynamics.
Conclusion. The minimally invasive approach and surgical tactics allow cardiac surgeons to use an
advanced technique with specific state-of-the-art instruments, video systems, involving a 3-5 cm incision,
in the right intercostal space IV or mini-sternotomy, frequently used in the surgical treatment of congenital
heart disease, compared to sternotomy. This type of intervention has a much lower negative impact on the
patient, by reducing bleeding and infection. The main visual advantage is reduced sedation period and
reduced hospitalisation days with rapid postoperative recovery.
