© Tommaso Hinna Danesi, MD 2021
TCS
Thoracoscopic Cardiac Surgery
Closed-Chest Procedures
Different cardiac procedures can be performed without opening the chest. Three small 5 to 12 mm trocars allow the Surgeon to bring into the chest instruments and devices needed to complete the procedure. This technique is well known and widely adopted in thoracic surgery, experienced Endoscopic Cardiac Surgeons apply this micro-invasive approach to several procedures. Benefits of a completely thoracoscopic procedure include potentially no wound infection, fast recovery and better aesthetic results. Usually these procedures don't need any cardio-pulmonary by-pass. It's a really micro-invasive beating heart cardiac surgery.
[Photo Source: Personal archive with Patient's permission]
Left Atrial Appendage Exclusion
Pericardial Effusion Drainage
Epicardial Pacing Wires
When the heart is skipping more than a beat a permanent pace-maker might be needed. To work these small kicking-engines need small wires be placed into the heart or on its surface. With a throacoscopic approach the Surgeon can secure the pacing-wire directly to the heart muscle. Recovery from the procedure is fast and usually the Patient can leave the hospital 24-36 hours later
Irregular heart beat is often due to an atrial fibrillation.
Atrial fibrillation is one of the most represented cardiac arrhythmia. This arrhythmia itself rarely is a lifethreatening condition, but without an appropriate anticoagulation strategy might lead to several catastrophic neurological issue like clots and strokes. The left atrial appendage, a small portion of the left atrium, is the place where thormbus occour during atrial fibrillation. Its ligation provides huge benefits in terms o cardioembolic stroke rate. With a thoracocopic procedure the Surgeon can deploy a specific device to occlude the left atrial appendage. Recovery after a thoracoscopic atrial appendage ligation is fast and usually the Patient can leave the hospital within 24-36 hours
When the heart doesn't have enough space to perform and is struggling compressed by surrounding fluid a pericardiocentisis is needed. As for epicardial pacing wire placement an Endoscopic Cardiac Surgeon can take the fluid out with a thoracoscopic approach
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Brigham and Women's Hospital, Heart and Vascular Center
Carl J. and Ruth Shapiro Cardiovascular Center
70 Francis Street
Boston, MA 02115
United States
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