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Commentary |
by Antonio
Calafiore, M.D.
San Camillo DeLellis Hospital, Chieti IT |
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What is Minimally Invasive Cardiac Surgery?
This definition was born to define the first procedure done: the LAST operation (MIDCAB), which combined a limited, non-sternotomy, surgical approach with a revascularization procedure, performed without CPB. With the development of different techniques with different targets, the definition remained, but the original concept changed. Both aspects of the initial procedure were considered as minimally invasive, the minimal approach and the no CPB option.
This led to questions not yet answered: Can a limited approach justify a more demanding surgical technique? Is the increased cost of heavy technology coherent with a surgical basic principle: a technique, to be valid, has to be done by everyone…. everywhere? In my opinion, the greatest achievement remains the possibility to perform some procedures without CPB, which remains the greatest invasiveness for the patient. Minimally invasive cardiac surgery is, in my opinion, cardiac surgery without CPB. What remains is non-sternotomy cardiac surgery and that is a different field.
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