Totally Endoscopic Surgery for Repairing Sinus Venosus Atrial Septal Defect Using Double-Patch Technique on Beating...

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Techniques
• Congenital Heart Defects

Background:

• Sinus venosus atrial septal defect (SV-ASD) repair traditionally uses open-heart surgery.
• Minimally invasive approaches for SV-ASD, especially with high anomalous pulmonary veins (APVs), are less established.
• The safety and efficacy of port-access repair for SV-ASD with APVs draining high to the superior vena cava (SVC) remain unclear.

Purpose of the Study:

• To evaluate the safety and effectiveness of port-access minimally invasive cardiac surgery for repairing SV-ASD with APVs draining high to the SVC.
• To assess the feasibility of a double-patch technique in this specific patient population.

Main Methods:

• A prospective study enrolled 11 consecutive patients with SV-ASD and high APVs connecting to the SVC.
• Procedures were performed using a single 12 mm port and two trocars, with CO2 insufflation.
• A double-patch technique was employed to redirect APV flow and enlarge the SVC-right atrial junction.

Main Results:

• No early or late deaths or reoperations occurred.
• Average cardiopulmonary bypass and operative times were 96 and 190 minutes, respectively.
• No venous stenosis or sinus node dysfunction was observed during a mean follow-up of 16.4 months.

Conclusions:

• Port-access minimally invasive cardiac surgery is a safe and effective method for repairing SV-ASD with APVs draining high to the SVC.
• The double-patch technique is suitable for this complex subset of SV-ASD patients.