Minimal Access Cardiac Surgery: State of the Art and Future Perspectives

As with all areas of surgical practice, there has been a move in recent years towards minimally invasive approaches to many operations. For example, VATS lobectomy is becoming the standard of care. In cardiac surgery, I think it is fair to term these approaches as minimal access, rather than minimally invasive, since the invasiveness of the surgery, in terms of cardiopulmonary bypass, cardioplegic arrest, the opening of cardiac chambers, and other aspects, is much the same. There is an increasing number of centres offering minimal-access cardiac surgery, and the range of procedures offered is expanding. Patients like the idea of minimal-access procedures for a range of reasons: improved cosmesis, the perception of faster recovery, and reduced pain. Interestingly, though, there remains some scepticism among the cardiac surgical community as to the true benefit of minimal-access cardiac surgery. Indeed, very few randomised controlled trials that compare outcomes to standard cardiac surgery remain.

In some ways, it is this scepticism that prompts this timely Special Issue Reprint, where the current status of minimal-access cardiac surgery has been explored, together with consideration of future advances and directions, in order to provide the cardiac surgical community with a robust contemporary review of the current literature.