• Zhi Xian Ong, Duoduo Wu, Haidong Luo, Guohao Chang, Faizus Sazzad, Jai Ajitchandra Sule, Peggy Hu, and Theo Kofidis.
• Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
• Singap Med J. 2022 Nov 1; 63 (11): 641648641-648.

IntroductionMinimally invasive cardiac surgery (MICS) has attracted increasing attention, with institutions increasingly adopting this approach over conventional median sternotomy (MS). This study aimed to describe the outcomes of minimally invasive cardiac surgery in our institution as the only centre with an established MICS programme in Singapore.MethodsPatients who had undergone cardiac procedures such as heart valve replacement or repair, coronary artery bypass grafting or atrial septal defect repair were included in the study. We analysed 4063 patients who had undergone MS and 390 patients who had undergone MICS between January 2009 and February 2020.ResultsOver the years, the number of MICS procedures performed increased, along with an increase in MICS operations with two or more concomitant cardiac procedures and a decrease in postoperative length of stay. Compared with patients who underwent MS, those who underwent MICS had shorter length of postoperative hospital stay (P < 0.001). On multivariate analysis, patients who underwent MICS had lower rates of atrial fibrillation (P = 0.021), reoperation (P = 0.028) and prolonged ventilation (P < 0.001). However, the rates of other postoperative complications were comparable between patients who underwent MICS and those who underwent MS.ConclusionIn our institution, MICS is a safe, reproducible and efficacious technique that yields superior outcomes compared with conventional MS procedures, in some aspects. The results of this study provide further evidence and support towards adopting the minimally invasive approach to cardiac surgery in a carefully selected group of cardiac patients in Singapore.

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