Use of da Vinci Xi for the minimally invasive cardiac procedures add value and precision in the form of improved dexterity, excellent vision, suitable ergonomics and patient safety. It hastens the patient's recovery with minimum complications and excellent results. Herein we performed Robotic Mitral valve replacement for a young female in her 50's referred from the neighbouring state with severe symptomatic mitral valve regurgitation. She was deferring surgery for more than 2 years due to fear of sternotomy and the scar. She had a fast track recovery (courtesy our fabulous anaesthesia team )and discharged in 3 days with no pain and no blood transfusion with superior cosmetic result.
2 female patients in their 80s underwent minimally invasive valve replacements on the same day.
1. 80 year old with severe symptomatic bicuspid aortic valve stenosis , well preserved, anaemic, no comorbidities and low euroscore underwent minimally invasive aortic valve replacement through right anterior approach with tissue valve. She underwent fast track recovery with minimal pain , no inotropes, early extubation and mobilised on first post operative day.
2. 80 yr old lady with severe calcific rheumatic mitral stenosis and mitral annular calcification and severe pulmonary artery hypertension and repeated admissions for pulmonary congestion underwent transaxillary mitral valve replacement with tissue valve. She had an early extubation, mobilised on first day with minimal pain and no blood transfusion.
It goes to show that minimally invasive cardiac surgeries is safe and effective in good risk old patients too.
Dr Sudarshan GT
Robotic and minimally invasive cardiac surgeon Fortis hospital, Bangalore
Acute massive PE with cardiogenic shock is a surgical emergency. The key to good surgical outcome is early diagnosis and surgical referral. Recently we had 2 cases in early 20s , chronic smokers, one with history of trauma and immobilisation and other with liposuction procedure done 2 weeks ago. Both had gradual worsening of symptoms since a week and came in cardiogenic shock.
You can appreciate the clot burden in the pulmonary system often underrated. The swift action multidisciplinary team of cardiologist, radiologist anaesthesiologist, perfusionist, intensivist, physio, nurses is paramount for a successful outcome.
Endoscopic Aortic Valve replacement in a symptomatic 70 yr old lady with severe AS with fixed severe AR and grade 3 osteoporosis. 4 cm RAT ( right anterior thoracotomy) incision, no bone cut, endoscopic assisted, excellent visualisation for decalcification and suture placement.
Fast track extubated, no blood transfusion, discharged in 3 days
Dr Sudarshan GT
Minimally invasive and Robotic Cardiac Surgeon Fortis Hospitals, Bangalore
70 yr old with tight long segment LAD disease, underwent Robotic LIMA harvesting with 4 CM incision over LAD and beating heart anastomosis using octopus nuvo.. Pt extubated on table, minimal analgesics, discharged on 3rd day
Dr Sudarshan GT
Senior Consultant minimally invasive cardiac surgeon Fortis hospital, Bannerghatta road
