Minimally Invasive Congenital Cardiac Surgery in Morocco: Outcomes and Technical Refinements

Area of Science:

• Cardiology
• Pediatric Surgery
• Minimally Invasive Surgery

Background:

• Minimally invasive approaches are gaining traction in congenital cardiac surgery.
• Their application in pediatric patients presents unique challenges.
• This study reports on clinical outcomes and technical refinements for these procedures.

Purpose of the Study:

• To evaluate the clinical outcomes of minimally invasive congenital cardiac surgery in pediatric patients.
• To describe technical refinements for these surgical approaches.
• To assess the feasibility and safety of minimally invasive techniques in a selected cohort.

Main Methods:

• Prospective observational single-center study of 31 pediatric patients.
• Procedures included atrial septal defects, ventricular septal defects, and partial atrioventricular septal defects.
• Utilized cardiopulmonary bypass with specific cannulation strategies (femoral arterial, jugular venous).

Main Results:

• Median age 145 months, median weight 32.5 kg; 23 females, 8 males.
• Mean aortic cross-clamp time: 51.2 min.
• 93.5% extubated within 3 hours; no operative mortality or sternotomy conversion. One patient (3.2%) required a permanent pacemaker for atrioventricular block.

Conclusions:

• Minimally invasive congenital cardiac surgery is feasible and safe in carefully selected pediatric patients.
• Satisfactory surgical results were observed with a minimum 12-month follow-up.
• These techniques should be integrated into contemporary congenital cardiac surgery programs.