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Background <p>Innovative perioperative strategies, such as enhanced recovery after surgery (ERAS) are gaining interest in modern cardiac surgery. These approaches not only aim to reduce the length of hospital stay but also hold the potential to reduce patient morbidity while improving recovery and patient satisfaction without compromising safety.</p> Objective <p>To evaluate the impact of the interdisciplinary ERAS program established at the German Heart Center of the Charité (Deutsches Herzzentrum Charité) “Enhanced recovery after minimally invasive cardiac surgery following a&#xa0;day zero concept” (ERMICS-D0) on morbidity, functional recovery and patient satisfaction following minimally invasive heart valve surgery.</p> Material and methods <p>In this prospective study 128 patients undergoing minimally invasive aortic or mitral valve surgery via right lateral thoracotomy are randomized in a&#xa0;1:1 ratio to either the standard of care or the ERMICS-D0 intervention group. The ERMICS-D0 protocol comprises a&#xa0;defined bundle of perioperative components and omits routine transfer to the intensive care unit on the day of surgery (day zero concept). Blood samples are collected at predefined time points to assess biomarkers of inflammation, organ dysfunction, malnutrition and muscle catabolism.</p> Results <p>A&#xa0;comparative analysis between the two groups is conducted in terms of clinical outcomes, morbidity including biomarker profiles, functional recovery and patient satisfaction.</p> Conclusion <p>The ERMICS-D0 program is expected to be associated with significant clinical benefits. The biomarker analyses could provide novel insights into the physiological advantages of a&#xa0;structured ERAS pathway avoiding postoperative treatment on the intensive care unit. The first results are anticipated within 2–3&#xa0;years.</p>

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Enhanced Recovery After Minimally Invasive Cardiac Surgery – eine prospektive randomisierte Studie

  • 期刊论文

  • 发表日期：

    2025年7月17日

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  • Leonard Pitts,
  • Christian Stoppe,
  • Tilman Grune,
  • Martina Dini,
  • Nadja Oestmann,
  • Kaan Kardes,
  • Lina Monse,
  • Markus Kofler,
  • Stephan Jacobs,
  • Matthias Hommel,
  • Volkmar Falk,
  • Benjamin O’Brien,
  • Jörg Kempfert

摘要

Background

Innovative perioperative strategies, such as enhanced recovery after surgery (ERAS) are gaining interest in modern cardiac surgery. These approaches not only aim to reduce the length of hospital stay but also hold the potential to reduce patient morbidity while improving recovery and patient satisfaction without compromising safety.

Objective

To evaluate the impact of the interdisciplinary ERAS program established at the German Heart Center of the Charité (Deutsches Herzzentrum Charité) “Enhanced recovery after minimally invasive cardiac surgery following a day zero concept” (ERMICS-D0) on morbidity, functional recovery and patient satisfaction following minimally invasive heart valve surgery.

Material and methods

In this prospective study 128 patients undergoing minimally invasive aortic or mitral valve surgery via right lateral thoracotomy are randomized in a 1:1 ratio to either the standard of care or the ERMICS-D0 intervention group. The ERMICS-D0 protocol comprises a defined bundle of perioperative components and omits routine transfer to the intensive care unit on the day of surgery (day zero concept). Blood samples are collected at predefined time points to assess biomarkers of inflammation, organ dysfunction, malnutrition and muscle catabolism.

Results

A comparative analysis between the two groups is conducted in terms of clinical outcomes, morbidity including biomarker profiles, functional recovery and patient satisfaction.

Conclusion

The ERMICS-D0 program is expected to be associated with significant clinical benefits. The biomarker analyses could provide novel insights into the physiological advantages of a structured ERAS pathway avoiding postoperative treatment on the intensive care unit. The first results are anticipated within 2–3 years.