Lower ministernotomy and fast tracking for atrial septal defect
Baskar Ranjith Karthekeyan1, Mahesh Vakamudi, Periyasamy Thangavelu
1Sri Ramachandra Medical College and Research Institute, No. 1 Ramachandra Nagar, Porur, Chennai-600116, Tamilnadu, India. ranjithb73@gmail.com
Asian Cardiovascular & Thoracic Annals
|March 23, 2010
Summary
A minimally invasive lower ministernotomy approach for atrial septal defect closure proved safe and effective in 53 patients. This technique offers cosmetic benefits and faster recovery, with most patients extubated in the operating room.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Minimally Invasive Procedures
Background:
- Atrial septal defects (ASDs) are commonly repaired via sternotomy.
- Minimally invasive techniques are increasingly explored to reduce surgical morbidity.
Purpose of the Study:
- To evaluate the safety and efficacy of a 3-5 cm lower ministernotomy incision for ASD closure.
- To assess outcomes including recovery time, cosmetic results, and complications.
Main Methods:
- Retrospective review of 53 patients undergoing ASD closure.
- Comparison of fibrillatory arrest versus crossclamping with cardioplegia.
- Analysis of operative times, bypass duration, and intensive care unit (ICU) stay.
Main Results:
- Successful closure in 51 of 53 patients using the ministernotomy approach.
- Mean bypass time: 39.6 min, arrest time: 9.9 min, crossclamp time: 20.7 min.
- Rapid recovery observed: mean extubation at 63.4 min, ICU stay 1.07 days, hospital stay 3.07 days.
Conclusions:
- Lower ministernotomy is a viable and safe approach for ASD closure.
- The technique provides excellent cosmetic results, minimal pain, and facilitates rapid patient recovery.
- This approach offers advantages over traditional sternotomy, including improved respiratory mechanics.
