Minimally invasive atrial septal defect closure
Pieter C van de Woestijne1, Frans B S Oei, Ad J J C Bogers
1Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands.
Insights
This study presents a video-assisted surgical approach for closing atrial septal defects (ASDs) using femoral cannulation and a small thoracotomy. This minimally invasive technique facilitates concurrent tricuspid valve surgery when needed.
Area of Science:
- Cardiology
- Thoracic Surgery
- Minimally Invasive Surgery
Background:
- Atrial septal defect (ASD) is a common congenital heart defect requiring intervention.
- While percutaneous closure is prevalent, surgical repair remains necessary for certain defects.
- Minimally invasive surgical techniques are evolving for ASD closure.
Purpose of the Study:
- To describe and illustrate a video-assisted surgical approach for ASD closure.
- To highlight the feasibility of performing concomitant tricuspid valve surgery with this method.
Main Methods:
- Video-assisted thoracoscopic surgery (VATS) approach.
- Femoral arterial and venous cannulation for cardiopulmonary bypass.
- Small thoracotomy incision for instrument and device placement.
- Surgical closure of the atrial septal defect.
Main Results:
- Successful closure of atrial septal defects using the described video-assisted technique.
- Demonstrated ease of performing additional tricuspid valve operations concurrently.
- Minimally invasive approach potentially offers advantages over traditional sternotomy.
Conclusions:
- Video-assisted closure of ASD with femoral cannulation and small thoracotomy is a viable surgical option.
- This technique allows for efficient combined procedures, including tricuspid valve repair or replacement.
- Further evaluation of this minimally invasive approach in larger patient cohorts is warranted.
Abstract:
Atrial septal defect (ASD) is the most common congenital cardiac disorder requiring intervention. Nowadays, most defects are closed percutaneously, but there will always remain defects that have to be closed surgically. In the past, techniques other than the standard median sternotomy approach have been advocated such as axial thoracotomy, lateral thoracotomy and limited sternotomy. In the last years, an increasing number of techniques of video-assisted mini-thoracotomy or full thoracoscopic methods including robotic-assisted operations have been described. Here, we describe and illustrate our experience with a video-assisted approach using femoral cannulation and a small thoracotomy for closure of an ASD. With this method, it is easy to perform a (additional) tricuspid valve operation at the same time, should this be indicated.
