Project R-11138

Clinical and patient-centered outcomes after totally endoscopic cardiac surgery (Research)

The current standard procedure to conduct cardiac surgery is a median sternotomy which is an incision through the chest bone. Wound infection and high morbidity and mortality can occur due to the sternotomy. The consequences include long hospital stays and a high cost for the healthcare system. Minimally invasive cardiac surgery (MICS) procedures, using only small 5-20 mm incisions, have been developed to reduce the surgical trauma. However, only limited results are available regarding the least invasive procedure: totally endoscopic surgery through trocar access. Therefore, we will provide an overview of the clinical outcomes of totally endoscopic cardiac surgery in a retrospective and prospective manner. This research focusses on the most commonly performed cardiac surgeries: totally endoscopic aortic valve replacement (AVR) and totally endoscopic coronary artery bypass graft (CABG). The outcomes that will be evaluated include patient history, intraoperative data and postoperative events such as stroke, rhythm problems and mortality. Secondly, we want to determine whether certain factors such as advanced age, insulin dependent diabetes, previous cardiac surgery and combinations of different types of surgery during one operation influence the outcome after totally endoscopic surgery. Finally, a prospective observational cohort study will compare these clinical outcomes between totally endoscopic AVR and transcatheter AVR. In this study, the quality of life (QoL) will be evaluated before the surgery and at different timepoints after the surgery. Additionally, we want to investigate with a randomized controlled trial if high-frequency ventilation during endo-CABG can improve the lung functioning after the surgery. The main goal of this project is to identify specific measures to improve the clinical outcomes and QoL after totally endoscopic cardiac surgery. In this way, these procedures can eventually become the state-of-the-art procedure for cardiac surgery.

16 October 2020 - 15 October 2024