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Individualized strategy of minimally invasive cardiac surgery in congenital cardiac septal defects
- Source :
- Journal of Cardiothoracic Surgery, Vol 17, Iss 1, Pp 1-9 (2022), Journal of Cardiothoracic Surgery
- Publication Year :
- 2022
- Publisher :
- Springer Science and Business Media LLC, 2022.
-
Abstract
- Background Intracardiac septal defect is repaired using median sternotomy in most centers; however, there are several reports using minimally invasive surgery in both children and adults. This study summarized our strategy of minimally invasive therapy using various lateral mini-thoracotomies in patients with congenital septal defect. Methods In this study, 472 patients who underwent minimally invasive repair of intracardiac septal defects (atrial septal defect, (ASD), ventricular septal defect, (VSD), and atrioventricular septal defect, (AVSD)) from January 2012 to June 2020 were retrospectively reviewed. Those who underwent device closure were excluded. The minimally invasive strategy included three groups: the right sub-axillary vertical incision (RSAVI) group (N = 335, including192 ASDs, 135 VSDs and 8 AVSDs); the right anterolateral thoracotomy (RALT) group (N = 132, including 77 ASDs, 51 VSDs and 4 AVSDs); and the left anterolateral thoracotomy (LALT) group (N = 5, all subpulmonary VSDs). Results Concomitant surgeries included nine cases of right ventricular outflow tract obstruction relief, nine cases of mitral repairs and 37 cases of tricuspid repairs. There was one transition from thoracotomy to sternotomy. Three patients required second pump run for residual lesions (two residual VSD shunts and one mitral regurgitation). The age and body weight of the RSAVI group were significantly lower than those of the RALT and LALT groups (all P Conclusions Intracardiac septal defects can be safely and effectively repaired by minimally invasive surgery with good cosmetic results. RSAVI is suitable in infants and children, while RALT is more commonly used in adolescents and adults. LALT is an alternative incision to repair subpulmonary VSD.
- Subjects :
- Adult
Pulmonary and Respiratory Medicine
congenital, hereditary, and neonatal diseases and abnormalities
medicine.medical_specialty
Adolescent
RD1-811
Heart Septal Defects, Atrial
Anesthesiology
medicine
Minimally invasive cardiac surgery
Humans
Minimally Invasive Surgical Procedures
RD78.3-87.3
cardiovascular diseases
Cardiac Surgical Procedures
Child
Retrospective Studies
Congenital heart disease
business.industry
Heart Septal Defects
Infant
General Medicine
Surgery
Treatment Outcome
Thoracotomy
Intracardiac septal defect
business
Cardiology and Cardiovascular Medicine
Research Article
Cardiac Septal Defects
Subjects
Details
- ISSN :
- 17498090
- Volume :
- 17
- Database :
- OpenAIRE
- Journal :
- Journal of Cardiothoracic Surgery
- Accession number :
- edsair.doi.dedup.....7d454a1f02800068b3063eb4dec9a302