Re-expansion XXXX after minimally invasive cardiac surgery with right mini-thoracotomy   .

@entity1 @entity4 @entity134
OBJECTIVES: Re-expansion @entity4 (RPO) sometimes occurs after minimally invasive cardiac surgery (MICS) with single-lung ventilation. However, it has not been widely recognized as a serious complication. The aim of this study is to evaluate the occurrence rate and risk factors of RPO. METHODS: A total of 381 consecutive @entity1 who underwent MICS with right mini-thoracotomy from March 2005 to October 2013 were retrospectively reviewed. RESULTS: RPO was observed in 8 (2.1%) @entity1 . In the preoperative data, greater percentages of preoperative use of @entity134 or immunosuppressant were found in @entity1 with RPO (25% [2/8] vs 1% [4/373]; P = 0.0056). In the operative data, significantly longer operation, cardiopulmonary bypass (CPB) and aortic cross-clamping (ACC) times as well as greater percentages of second CPB run were found in @entity1 with RPO (388    80 vs 272    61 min; P < 0.0002, 253    79 vs 158    50 min; P = 0.0009, 162    65 vs 108    38 min; P = 0.020 and 38% [3/8] vs 1.3% [5/373]; P < 0.0003). The overall 30-day mortality rate was 0.8% (3/381) and the 30-day mortality rate of @entity1 with RPO was 12.5% (1/8). Significantly prolonged initial ventilation time, intensive care unit and postoperative hospital stay were observed in @entity1 with RPO (P = 0.0022, <0.0001 and 0.0003, respectively). Multivariate logistic analysis detected preoperative use of @entity134 or immunosuppressant and prolonged ACC time (>= 156 min) as independent risk factors for RPO after MICS (odds ratio [OR]: 87.6 [95% confidence interval, CI: 4.1-2463.8]; P = 0.006 and OR: 36.0 [95% CI: 4.8-731.4]; P < 0.001). CONCLUSIONS: RPO should be recognized as one of the most serious complications after MICS with right mini-thoracotomy. More accurate risk factors of prolonged lung malperfusion and @entity134 use on RPO after MICS should be investigated.
