Minimally Invasive Surgical Repair of Simple Congenital Heart Defects Using the Right Vertical Infra-Axillary
Dien Minh Tran1, Vinh Quang Tran2, Mai Tuan Nguyen2
1Department of Surgical ICU, Vietnam National Children's Hospital, Hanoi, Vietnam.
Innovations (Philadelphia, Pa.)
|August 26, 2024
Summary
The minimally invasive right vertical infra-axillary minithoracotomy (RVIAT) approach is safe and effective for repairing simple congenital heart defects (CHD). This technique offers a viable alternative to traditional median sternotomy for pediatric cardiac surgery.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Minimally Invasive Techniques
Background:
- Congenital heart defects (CHD) are common birth abnormalities requiring surgical intervention.
- Traditional open-heart surgery using median sternotomy carries risks and a lengthy recovery period.
- Minimally invasive surgical approaches are increasingly explored to improve outcomes in pediatric cardiac surgery.
Purpose of the Study:
- To evaluate the safety and efficacy of the right vertical infra-axillary minithoracotomy (RVIAT) approach for surgical repair of simple congenital heart defects (CHD).
- To compare RVIAT outcomes with historical data from median sternotomy procedures.
- To assess the feasibility of RVIAT in a pediatric population with various simple CHDs.
Main Methods:
- Retrospective review of clinical data from 382 patients who underwent RVIAT for CHD repair between August 2019 and August 2022.
- Analysis of perioperative data, including cross-clamp time, bypass time, operation time, and complication rates.
- Inclusion of patients with diagnoses such as ventricular septal defect, atrial septal defect, and atrioventricular septal defect.
Main Results:
- No in-hospital mortality or conversion to median sternotomy was observed.
- Low rates of reoperation (0.5%) for bleeding or pacemaker implantation.
- Minor complications included trivial residual shunts (6%), pleural effusion (0.8%), pneumothorax (0.8%), and wound infection (1%).
- Two late noncardiac deaths and one late reoperation for aortic valve regurgitation were reported.
Conclusions:
- The RVIAT approach is a safe and effective minimally invasive option for repairing simple congenital heart defects (CHD).
- RVIAT demonstrates favorable short-term and long-term outcomes, with low complication rates.
- This technique presents a promising alternative to conventional median sternotomy for selected pediatric cardiac procedures.
