Totally Thoracoscopic Surgical Treatment for Atrial Septal Defect: Mid-Term Follow-up Results in 45 Consecutive Patients

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• 作者：Gaoli Liu ; MD^a ; ^b ; ^{surgeon001@163.com} ; Yanli Qiao ; MD^b ; Chengwei Zou ; MD^a ; Liming Ma ; MD^b ; Liangchun Ni ; MD^b ; Shanguang Zeng ; MD^b ; Xiang Li ; MD^b ; Qianjin Cheng ; MD^b
• 关键词：Thoracoscopy ; Minimally invasive cardiac surgery ; Atrial septal defect ; Congenital heart disease
• 刊名：Heart, Lung and Circulation
• 出版年：2013
• 出版时间：February, 2013
• 年：2013
• 卷：22
• 期：2
• 页码：88-91
• 全文大小：280 K

文摘

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Background

Totally thoracoscopic operation provides minimally invasive alternative for patients with atrial septal defect. In this study, we report the mid-term follow-up results of 45 patients with atrial septal defect who underwent totally thoracoscopic operation and discuss the feasibility and safety of this new technique.

Methods

From January 2010 to February 2012, 45 patients with atrial septal defect underwent totally thoracoscopic closure as an alternative to traditional median sternotomy surgery. The mean age of the patients was 33.2 ¡À 12.5 years (range 6.3-61.5 years), and mean weight was 55.7 ¡À 11.1 kg (range 30.5-80 kg). Based on echocardiography the mean size of the atrial septal defect was 16.0 ¡À 10.8 mm (range 13-39 mm).

Results

All patients underwent totally thoracoscopic repair. Twenty-five patients with a pericardial patch and 20 patients were sutured directly. Five patients underwent concomitant tricuspid valvuloplasty with Kay technique. No death, reoperation or complete atrioventricular block occurred. The mean time of cardiopulmonary bypass was 70.5 ¡À 20.6 min (range 31.0-153.0 min), the mean time of aortic cross-clamp was 28.8 ¡À 13.3 min (range 0.0-80.0 min) and the mean time of operation was 155.8 ¡À 36.8 min (range 65.0-300.0 min). Postoperative mechanical ventilation averaged 5.1 ¡À 2.8 h (range 3.6-12.6 h), and the duration of intensive care unit stay 20.0 ¡À 5.6 h (range 16.2-25 h). The mean volume of blood drainage was 156 ¡À 36 ml (range 51-800 ml). No death, residual shunt, lung atelectasis or moderate tricuspid regurgitation was found at three-month follow-up.

Conclusion

Totally thoracoscopic repair is feasible and safe for patients with ASD, even with or without tricuspid regurgitation however more clinical data is needed in the future study.