Abstract：
OBJECTIVE: The aims of the present study were to evaluate and compare the safety and feasibility, including hospitalization, intensive care unit (ICU) stay, frequency of conversion to general anesthesia (GA), pH, PaCO2, and PaO2, of selected patients who underwent minimally invasive mitral valve surgery (MIMVS) via a right minithoracotomy under conscious sedation (CS) to avoid GA. The authors also aimed to evaluate the perioperative management of spontaneous breathing.
METHODS: A retrospective, observational study.
METHODS: Single-center.
METHODS: This study enrolled 101 patients who underwent MIMVS under CS or GA.
METHODS: The patients who underwent MIMVS were managed under CS or GA according to indication criteria.
RESULTS: ICU stay (p = 0.010), postoperative time until first fluid intake (p < 0.0001), and duration of mechanical ventilation (p = 0.004) were shorter in the CS group than in the GA group. No patients converted to GA from CS. PaCO2 during cardiopulmonary bypass (CPB) in the CS group was significantly lower than that in the GA group. However, PaCO2 at the termination of CPB in the CS group was significantly higher than that in the GA group.
CONCLUSIONS: In the CS group, advanced-age patients with comorbidities underwent mitral surgery without postoperative complications. The authors\' findings suggested that MIMVS under CS could be a potentially less-invasive method, providing a quicker recovery than MIMVS under GA.
METHODS: A retrospective, observational study.
METHODS: Single-center.
METHODS: This study enrolled 101 patients who underwent MIMVS under CS or GA.
METHODS: The patients who underwent MIMVS were managed under CS or GA according to indication criteria.
RESULTS: ICU stay (p = 0.010), postoperative time until first fluid intake (p < 0.0001), and duration of mechanical ventilation (p = 0.004) were shorter in the CS group than in the GA group. No patients converted to GA from CS. PaCO2 during cardiopulmonary bypass (CPB) in the CS group was significantly lower than that in the GA group. However, PaCO2 at the termination of CPB in the CS group was significantly higher than that in the GA group.
CONCLUSIONS: In the CS group, advanced-age patients with comorbidities underwent mitral surgery without postoperative complications. The authors\' findings suggested that MIMVS under CS could be a potentially less-invasive method, providing a quicker recovery than MIMVS under GA.
摘要：
目的：本研究的目的是评估和比较安全性和可行性，包括住院,重症监护病房(ICU)入住,转换为全身麻醉（GA）的频率，pH值,在清醒镇静（CS）下通过右小开胸手术进行微创二尖瓣手术（MIMVS）以避免GA的部分患者的PaCO2和PaO2。作者还旨在评估自主呼吸的围手术期管理。
方法：回顾性研究，观察性研究。
方法：单中心。
方法：本研究纳入101例CS或GA下接受MIMVS的患者。
方法：接受MIMVS的患者根据适应症标准在CS或GA下进行管理。
结果：ICU住院（p=0.010），术后时间直到第一次液体摄入（p<0.0001），CS组的机械通气时间（p=0.004）短于GA组。没有患者从CS转换为GA。CS组体外循环(CPB)期间PaCO2明显低于GA组。然而,CPB终止时CS组PaCO2明显高于GA组。
结论：在CS组中，有合并症的高龄患者接受二尖瓣手术,无术后并发症.作者的研究结果表明，CS下的MIMVS可能是一种潜在的微创方法，提供比GA下的MIMVS更快的恢复。
方法：回顾性研究，观察性研究。
方法：单中心。
方法：本研究纳入101例CS或GA下接受MIMVS的患者。
方法：接受MIMVS的患者根据适应症标准在CS或GA下进行管理。
结果：ICU住院（p=0.010），术后时间直到第一次液体摄入（p<0.0001），CS组的机械通气时间（p=0.004）短于GA组。没有患者从CS转换为GA。CS组体外循环(CPB)期间PaCO2明显低于GA组。然而,CPB终止时CS组PaCO2明显高于GA组。
结论：在CS组中，有合并症的高龄患者接受二尖瓣手术,无术后并发症.作者的研究结果表明，CS下的MIMVS可能是一种潜在的微创方法，提供比GA下的MIMVS更快的恢复。
