• Hirotsugu Kanda, Yukako Takahashi, Ami Sugawara, Kenichi Takahoko, Tomonori Shirasaka, Yasuaki Saijo, and Hiroyuki Kamiya.
• Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, Asahikawa, Japan. Electronic address: h.kanda0629@nifty.com.
• J. Cardiothorac. Vasc. Anesth. 2022 Feb 1; 36 (2): 452-460.

ObjectivesThe aims of the present study were to evaluate and compare the safety and feasibility, including hospitalization, intensive care unit (ICU) stay, frequency of conversion to general anesthesia (GA), pH, PaCO2, and PaO2, of selected patients who underwent minimally invasive mitral valve surgery (MIMVS) via a right minithoracotomy under conscious sedation (CS) to avoid GA. The authors also aimed to evaluate the perioperative management of spontaneous breathing.DesignA retrospective, observational study.SettingSingle-center.ParticipantsThis study enrolled 101 patients who underwent MIMVS under CS or GA.InterventionsThe patients who underwent MIMVS were managed under CS or GA according to indication criteria.Measurements And Main ResultsICU stay (p = 0.010), postoperative time until first fluid intake (p < 0.0001), and duration of mechanical ventilation (p = 0.004) were shorter in the CS group than in the GA group. No patients converted to GA from CS. PaCO2 during cardiopulmonary bypass (CPB) in the CS group was significantly lower than that in the GA group. However, PaCO2 at the termination of CPB in the CS group was significantly higher than that in the GA group.ConclusionsIn the CS group, advanced-age patients with comorbidities underwent mitral surgery without postoperative complications. The authors' findings suggested that MIMVS under CS could be a potentially less-invasive method, providing a quicker recovery than MIMVS under GA.Copyright © 2021 Elsevier Inc. All rights reserved.

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