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New Clinical Advances in Minimally Invasive Cardiac Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 30 September 2025 | Viewed by 1854

Special Issue Editor


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Guest Editor
Department of Thoracic and Cardiovascular Surgery, German Cardiac Competence Center, Eberhard-Karls-University of Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen, Germany
Interests: adult cardiac surgery; heart failure; coronary artery bypass grafting; valve ssurgery

Special Issue Information

Dear Colleagues,

Minimally invasive cardiac surgery (MICS) represents a transformative approach in cardiovascular medicine, offering significant advantages over traditional open-heart surgery. This Special Issue aims to explore the latest clinical advances, techniques, and outcomes in MICS, with a focus on improving patient outcomes, reducing hospital stays, and minimizing surgical complications.

Recent years have seen substantial progress in the field, including the development of sophisticated surgical tools, enhanced imaging techniques, and innovative procedural approaches. Despite these advancements, several challenges remain, such as optimizing patient selection, refining surgical methods, and managing postoperative complications.

We welcome original insightful research articles and comprehensive reviews that address the core problems in MICS in the broadest sense. Areas of interest include, but are not limited to, advancements in valve surgery, coronary artery bypass grafting, and heart failure management through minimally invasive procedures. This includes all aspects related to MICS, including the surgical approach, but also encompassing preoperative screening, postoperative care, and both short- and long-term outcomes.

This Special Issue seeks to gather contributions from leading experts in the field to provide a comprehensive overview of current practices and future directions. We encourage submissions that present new data, share clinical experiences, and propose novel solutions to existing challenges in MICS.

Dr. Christian Rustenbach
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • minimally invasive cardiac surgery
  • valve surgery
  • coronary artery bypass grafting
  • heart failure management
  • surgical techniques

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Published Papers (2 papers)

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Research

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12 pages, 486 KB  
Article
Ultrasound-Guided Deep Parasternal Intercostal Plane Block in Off-Pump Cardiac Arterial Bypass Surgery: A Retrospective Cohort Single Center Study
by Kristian-Christos Ngamsri, Roman Tilly, Sabine Hermann, Christian Jörg Rustenbach, Medhat Radwan, Eckhard Schmid, Christophe Charotte, Lina Maria Serna-Higuita and Harry Magunia
J. Clin. Med. 2025, 14(13), 4756; https://doi.org/10.3390/jcm14134756 - 4 Jul 2025
Viewed by 483
Abstract
Background/Objectives: Sternal pain after cardiac surgery results in considerable discomfort and may contribute to the development of chronic postoperative sternal pain syndrome. Parasternal intercostal plane blocks have been shown to improve postoperative sternal pain and can be an essential part of enhanced [...] Read more.
Background/Objectives: Sternal pain after cardiac surgery results in considerable discomfort and may contribute to the development of chronic postoperative sternal pain syndrome. Parasternal intercostal plane blocks have been shown to improve postoperative sternal pain and can be an essential part of enhanced recovery after cardiac surgery (ERACS). This cohort study evaluated the postoperative impact of a single-shot deep parasternal intercostal plane block (PIPB) on the requirement of analgesic medication and pain sensation up to 48 h. Methods: This retrospective single-center analysis evaluates the postoperative acute pain in 157 patients undergoing off-pump coronary artery bypass (OPCAB) with median sternotomy. The additive analgesic effects of deep PIPB (38 patients) were compared to a group with standard therapy but without PIPB (119 patients). To strengthen the findings, a propensity score matching analysis was performed. Outcomes included the consumption of emergency pain agents (piritramide), the requirement of the total morphine equivalent (ME), time to extubation, and ICU length of stay. Furthermore, we examined pain sensation with evaluation by using the behavioral pain score (BPS) and numeric rating score (NRS) up to 48 h after extubation. Results: The deep PIPB reduced the piritramide administration 24 h and 48 h after OPCAB surgery. Moreover, the requirement of ME was 24 h and 48 h after bypass surgery also significantly decreased. The one-to-one propensity score matching confirmed our primary findings and showed a decreased requirement for intravenous agents. Additionally, we observed a reduced time for extubation and a decreased NRS rating. However, no significant changes were observed in ICU length of stay, incidence of nausea, and vomiting. Conclusions: Our data suggests that an ultrasound-guided single-shot deep PIPB can be a valuable tool for a multimodal analgesic protocol on patients undergoing OPCAB surgery. Full article
(This article belongs to the Special Issue New Clinical Advances in Minimally Invasive Cardiac Surgery)
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Review

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14 pages, 249 KB  
Review
New Clinical Advances in Minimally Invasive Coronary Surgery
by Shahzad G. Raja
J. Clin. Med. 2025, 14(9), 3142; https://doi.org/10.3390/jcm14093142 - 1 May 2025
Viewed by 876
Abstract
Background: Minimally invasive coronary surgery (MICS) has emerged as an alternative approach in the surgical management of coronary artery disease (CAD), offering potential advantages such as reduced surgical trauma, shorter hospital stays, and faster recovery. While conventional coronary artery bypass grafting (CABG) remains [...] Read more.
Background: Minimally invasive coronary surgery (MICS) has emerged as an alternative approach in the surgical management of coronary artery disease (CAD), offering potential advantages such as reduced surgical trauma, shorter hospital stays, and faster recovery. While conventional coronary artery bypass grafting (CABG) remains the standard treatment for severe CAD, MICS has seen variable adoption due to concerns over procedural complexity, the risk of incomplete revascularization, and the increasing role of percutaneous interventional techniques. Objectives: This review examines recent clinical developments in MICS, analyzing its techniques, technological advancements, and the impact on patient outcomes, while also addressing its limitations. Methods: This narrative review incorporates studies from PubMed, tracing the evolution of coronary surgery, the refinement of minimally invasive approaches, and the innovations that have enabled the selective implementation of MICS. This review evaluates robot-assisted coronary surgery and totally endoscopic coronary revascularization, discussing their clinical indications and comparative outcomes. Results: Advances in imaging, surgical instrumentation, and anesthesia have improved procedural safety and precision, yet MICS remains a selectively utilized technique rather than a universally preferred alternative. Comparative studies demonstrate mixed clinical outcomes, highlighting both the recovery benefits and technical challenges associated with MICS. Discussion: Patient selection, preoperative planning, and individualized surgical strategies play a crucial role in optimizing the effectiveness of MICS. Challenges include technical complexity, integration into broader clinical practice, and the need for procedural refinement. While ongoing research continues to address these hurdles, the role of MICS in CAD management remains context-dependent, influenced by case complexity and institutional expertise. Conclusion: MICS presents an evolving surgical approach with defined benefits and limitations, requiring careful patient selection and procedural optimization for the best outcomes. This review provides a comprehensive evaluation of recent advances in MICS while acknowledging its challenges and selective application in coronary surgery. Full article
(This article belongs to the Special Issue New Clinical Advances in Minimally Invasive Cardiac Surgery)
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