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Published on: February 8, 2022
Minimal-Access Atrial Septal Defect (ASD) Closure
Gillian Hardman1, Joseph Zacharias1
1Department of Cardiothoracic Surgery, Blackpool Victoria Hospital, Blackpool FY3 8NR, UK.
Insights
Minimally invasive techniques for atrial septal defect (ASD) closure are evolving, offering various approaches for adult and pediatric patients. This review examines current evidence for these less invasive cardiac surgery options.
Area of Science:
- Cardiovascular Surgery
- Congenital Heart Disease
- Minimally Invasive Techniques
Background:
- Minimally invasive cardiac surgery adoption lags behind other specialties.
- Atrial septal defect (ASD) is a common congenital heart disease.
- ASD management includes diverse minimal-access and minimally invasive options.
Purpose of the Study:
- To discuss ASD pathophysiology, diagnosis, and management.
- To review evidence for minimally invasive ASD closure in adults and children.
- To highlight peri-operative factors and future research needs.
Main Methods:
- Review of current literature on ASD management.
- Analysis of evidence supporting various minimally invasive techniques.
- Discussion of peri-operative considerations for ASD closure.
Main Results:
- Multiple minimally invasive approaches exist for ASD closure.
- Evidence supports these techniques in both adult and pediatric populations.
- Peri-operative care and further research are crucial.
Conclusions:
- Minimally invasive ASD closure is a viable option with various techniques.
- Further research is needed to optimize outcomes and expand adoption.
- Patient selection and tailored approaches are key for successful ASD management.
Abstract:
Progress towards the development and adoption of minimally invasive techniques in cardiac surgery has been slower than that seen in other surgical specialties. Congenital heart disease (CHD) patients represent an important population within cardiac disease, of which atrial septal defect (ASD) is one of the most common diagnoses. Management of ASD encompasses a range of minimal-access and minimally invasive approaches, including transcatheter device closure, mini-sternotomy, thoracotomy, video-assisted, endoscopic, and robotic approaches. In this article, we will discuss the pathophysiology of ASD, along with diagnosis, management, and indications for intervention. We will review the current evidence supporting minimally invasive and minimal-access surgical ASD closure in the adult and paediatric patient, highlighting peri-operative considerations and areas for further research.
