Minimally Invasive Surgery for Congenital Heart Disease

Minimally invasive cardiac surgery for congenital heart disease has gained increasing acceptance within the specialty. However, most suitable candidates are still treated with a conventional median sternotomy. Adoption of minimally invasive techniques has proven essential in the surgical repair of acquired heart disease to increase patient satisfaction and to remain competitive in an ever-changing medical field. We herein summarize the currently available literature on minimally invasive congenital heart surgery. We describe available techniques and routes of access as well as the lesions amenable for minimally invasive repairs. Mainly derived from case series and smaller retrospective studies, we report available evidence on outcome, especially compared with conventional repairs through a median sternotomy. We highlight the unique challenges that arise from the wide range of lesions as well as from the spectrum of patients, ranging from infant to adulthood, and describe ways to mitigate those.