Minimal Invasive Technique in Atrial Septal Defect Surgery

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiac Surgery

Background:

• Conventional median sternotomy for atrial septal defect (ASD) repair can be invasive.
• Minimally invasive techniques, including modified anterior mini-thoracotomy (MAMT) and median sternotomy with minimal skin incision (MSWMSI), offer alternatives.

Purpose of the Study:

• To detail the MAMT and MSWMSI techniques for ASD repair.
• To evaluate the outcomes of these innovative surgical approaches.

Main Methods:

• 54 children with ASD underwent repair using either MAMT or MSWMSI between May 2010 and May 2013.
• Intraoperative and postoperative variables were meticulously recorded, including bypass times, incision length, and complication rates.

Main Results:

• Mean cardiopulmonary bypass time was 30 ± 11 min; aortic cross-clamp time averaged 7 ± 2 min.
• Low rates of complications were observed, with superficial skin infection in 3 patients and subcutaneous hematoma/seroma in 6.
• Procedures successfully repaired secundum ASD (50 cases), sinus venosus ASD (2 cases), and associated VSDs (2 cases).

Conclusions:

• Both MAMT and MSWMSI are safe and effective surgical options for secundum ASD repair across all age groups.
• These minimally invasive techniques are also suitable for more complex ASD repairs, such as sinus venosus type.