Cardiothoracic Surgery: Cardiothoracic Surgery |

Awake Video-Assisted Thoracic Surgery (AVATS): Performing Complex Thoracic Surgical Procedures Without General Anesthesia FREE TO VIEW

Ara Klijian, MD
Author and Funding Information

Sharp/Scripps Hospitals, San Diego, CA

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):30A. doi:10.1016/j.chest.2016.08.037
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SESSION TITLE: Cardiothoracic Surgery

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: Video assisted thoracic surgery (VATS) has become the standard for lung surgery. Traditionally VATS requires use of general anesthesia and selective lung ventillation. In 2014, we published our experience with awake VATS performed under local anesthesia (AVATS) extending the benefit of VATS to patients unable to tolerate a general anesthetic. Many of the patients had FEV1 less than 1 and were not considered safe for general anesthesia. We have extended this technique to include more complex procedures with results that surpass traditional VATS.

METHODS: We analyzed 494 cases of AVATS performed from June 2010 to january 2016 including complex cases such as lobectomies, decortications, bullectomies, bronchopleural fistula repair and esophageal perforation repair all performed without general anesthesia using minimally invasive techniques to extend surgical option to patients who would have been considered inoperable from a diminnished pulmonary reserve, improve results and shorten length of stay.

RESULTS: During the same time period 265 traditional VATS cases and 134 open thoraqcotomies were also performed and the AVATS cases demonstated safety in performing surgery via AVATS in patients considered too high risk from an anesthetic viewpoint due to diminished pulmonary reserve, while demonstrating improved outcomes, lowere morbidity/mortality and shorter length of stay.

CONCLUSIONS: AVATS is a safe, effective way to perform complex lung procedures in patients with results that srpase traditional VATS while exptending the surgical option to patients once considered inoperable from a pulmonary viewpoint.

CLINICAL IMPLICATIONS: AVATS is a safe, reliable way to perform complex lung surgery in patients who would otherwise be considered inoperable due to suppress pulmonary status while demonstating low morbidity/mortality, improved outcomes and shorter length of stay.

DISCLOSURE: The following authors have nothing to disclose: Ara Klijian

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