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Port Access surgery for congenital heart disease
U Kappert1, F M Wagner, V Gulielmos
1Cardiovascular Institute, University Dresden, Germany.
Objectives:
Minimally invasive surgical techniques have been introduced into cardiac surgery in order to avoid median sternotomy related complications. Surgical trauma to the patient can be significantly reduced without compromising the safety. In addition, a small lateral chest incision results in improved cosmesis, especially in female patients.
Methods:
Thirteen patients (median age 39 +/- 14 years, ranged from 17-61 years) with atrial septal defect were treated with a minimally invasive surgical method using a modified Port Access technique. In all patients access to the heart was achieved via a small (4-8 cm) right lateral chest incision in the 4th intercostal space. In these patients the selection of the Port Access system was used for cardiopulmonary bypass via the femoral vessel and for the application of cardioplegic solution.
Results:
No deaths or intraoperative complications were observed in any of the patients. The postoperative course was uneventful and only minor complications were observed postoperatively. The median hospital stay was 8.0 +/- 1 days (median +/- SEM).
Conclusion:
This minimally invasive surgical technique for the treatment of atrial septal defects represent a safe alternative to conventional treatment of ASD using median sternotomy and standard cardiopulmonary bypass. The exposure of the right atrium via the 4th intercostal space is ideal and can be performed with excellent cosmetic results.