Atrial Septal Defect Closure Via Mini Thoracotomy and with Peripheral Cannulation
Anil Bhattarai1, Basanta Sharma Paudel2, Sangam Shah3
1Department of Cardiology, Institute of Medicine, Tribhuvan University, Maharajgunj, 44600, Nepal.
Journal of Nepal Health Research Council
|May 26, 2022
Summary
Minimally invasive atrial septal defect closure using total peripheral cannulation offers a safe and effective alternative to traditional median sternotomy. This approach results in smaller incisions and comparable patient outcomes, enhancing recovery.
Area of Science:
- Cardiovascular Surgery
- Congenital Heart Disease
- Minimally Invasive Procedures
Background:
- Atrial septal defect (ASD) is a common congenital heart defect requiring intervention.
- Traditional surgical closure involves median sternotomy.
- Minimally invasive techniques are being explored to improve outcomes.
Purpose of the Study:
- To compare the efficacy and safety of minimally invasive ASD closure with total peripheral cannulation and anterior mini-thoracotomy versus median sternotomy.
- To evaluate differences in perioperative variables and outcomes between the two surgical approaches.
Main Methods:
- Retrospective cross-sectional study comparing patients undergoing ASD closure via minimally invasive (mini-thoracotomy) and median sternotomy approaches.
- Data collected included preoperative variables, intraoperative details, and postoperative outcomes.
- Fifty-five patients in each group were analyzed.
Main Results:
- The minimally invasive group had significantly smaller incision sizes, shorter cardiopulmonary bypass times, and reduced initial fluid drainage.
- Mean intensive care unit (ICU) stay was shorter in the mini-thoracotomy group (1.8 days) compared to the median sternotomy group (2.5 days).
- Overall hospital length of stay was comparable (4.5 days vs. 4.8 days).
Conclusions:
- Minimally invasive ASD closure with total peripheral cannulation is a safe and cost-effective procedure.
- This approach is associated with minimal perioperative complications and high patient satisfaction.
- It presents a viable alternative to conventional median sternotomy for ASD repair.
