Minimally Invasive Periareolar Approach to Unroofed Coronary Sinus Atrial Septal Defect Repair

Less invasive techniques are commonly used to treat patients with anatomically suitable secundum atrial septal defects; however, repair of more complex atrial septal defects are still performed through sternotomy. Cosmetically appealing periareolar incisions have been used in breast reconstructive surgery and may provide an esthetically superior alternative to the anterolateral minithoracotomy incision used in minimally invasive cardiac surgery. We describe a patient with an unroofed coronary sinus atrial septal defect who underwent successful minimally invasive, endoscopic repair of this defect with autologous pericardial baffle reconstruction of the coronary sinus roof and closure of the interatrial communication through a periareolar approach.