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증례보고 : 수술 로봇을 이용한 심방중격결손 수술의 마취
최용선 ( Yong Seon Choi ),곽영란 ( Young Lan Kwak ),전동혁 ( Dong Hyuk Jeon ),홍용우 ( Yong Woo Hong ),박한기 ( Han Ki Park ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.3
Minimally invasive cardiac surgery including robotic technique has become increasingly popular over the last decade. The advantages of such technique include improved cosmesis and healing, and reduced stress response, hospital and intensive care unit stay, and transfusion requirements. Robot-assisted cardiac surgery requires prolonged one-lung ventilation to optimize exposure. Remote-access perfusion requires appropriate positioning of multiple catheters to establish cardiopulmonary bypass. Carbon dioxide insufflation into the thorax can cause hemodynamic instability and carbon dioxide embolism. Limited exposure of the heart may pose difficulties with management of arrhythmia, hemostasis, myocardial protection and de-airing at the end of surgery. Limited access due to robot manipulator would make rapid intervention for cardiopulmonary resuscitation difficult or impossible. This case report describes robot-asssisted atrial septal defect repair and discusses the anesthetic issues associated with minimally invasive cardiac surgery including robotic cardiac surgery. (Korean J Anesthesiol 2007; 52: 371~5)