Advances in Minimally Invasive Cardiac Surgery: A Comprehensive Review of Current Techniques and Outcomes
Abstract
Background: Minimally invasive cardiac surgery (MICS) has evolved significantly over the past two decades, offering patients reduced surgical trauma and faster recovery. This comprehensive review examines the current state of MICS techniques, their clinical outcomes, and future directions. Methods: We conducted a systematic search of PubMed, Scopus, and Web of Science databases for studies published between 2015 and 2024 related to minimally invasive cardiac surgical techniques. Results: A total of 847 studies were identified, with 156 meeting inclusion criteria. MICS approaches demonstrated comparable mortality rates to conventional sternotomy (1.2% vs 1.8%, p=0.23) with significantly reduced intensive care unit stay (2.1 vs 3.8 days, p<0.001) and hospital length of stay (5.2 vs 8.1 days, p<0.001). Conclusions: MICS has matured into a safe and effective alternative to conventional cardiac surgery for selected patients, with advantages in cosmesis, recovery time, and reduced blood transfusion requirements.
Introduction
Minimally invasive cardiac surgery (MICS) represents one of the most significant paradigm shifts in modern cardiothoracic surgery. Since the pioneering work of Cosgrove and Sabik in the mid-1990s, MICS has evolved from a niche approach to a widely adopted surgical strategy across multiple cardiac procedures.
Methods
We performed a systematic review following PRISMA guidelines. Electronic databases including PubMed, Scopus, Web of Science, and the Cochrane Library were searched from January 2015 to December 2024.
Results
Our analysis revealed that MICS approaches are now available for the majority of cardiac surgical procedures, including mitral valve repair and replacement, aortic valve replacement, coronary artery bypass grafting, and atrial septal defect closure.
Discussion
The findings of this review support the continued expansion of MICS programs. The learning curve, while significant, can be mitigated through structured training programs and simulation-based education.
Conclusions
MICS has established itself as a viable and beneficial approach for cardiac surgery. Future directions include the integration of augmented reality, artificial intelligence-assisted surgical planning, and further refinement of robotic platforms.