Video-assisted cardioscopy in congenital heart operations

Recent advances in fiberoptics and endoscopic imaging technology have extended the applications of video assistance in surgical procedures. Video-assisted thoracoscopic surgical techniques have been employed to improve anatomic visualization within the pleural space and to reduce chest wall trauma. Open heart operations for congenital heart disease in neonates and infants also require clear visualization of small structures within confined spaces. By adapting pediatric thoracoscopic instrumentation, we have developed a technique for video-assisted cardioscopy. This technique was used in 4 patients with complex congenital heart disease to expose remote intracardiac structures and facilitate surgical repair. The patients ranged in weight from 4.6 to 17 kilograms, and visualization of the intended structures was achieved in each case within 12 minutes. There were no complications associated with the videoscope. Further experience with video-assisted cardioscopy might broaden its role as an adjunct to the surgical repair of complex congenital heart defects.