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Totally Endoscopic Atrial Septal Defect Repair On The Beating Heart Without Robotic Assistance: Initial Results In 25 Patients
Huy Q. Dang, Le Ngoc Thanh, MD, PhD.
Cardiovascular center, E hospital, Hanoi, Viet Nam.
OBJECTIVE: Totally endoscopic operation has been applied for treatment of certain congenital heart diseases.
METHODS: We report 25 patients (15 adults and 10 children) underwent totally endoscopic atrial septal defect (ASD) repair on the beating heart without robotic assistance. Setting up peripheral extracoporeal circulation with direct or indirect femoral artery cannulation; SVC and IVC cannulation with Seldinger technique. Placing three 5mm trocars and one 12mm trocar, only tightening the SVC, filling the pleural and cardiac cavity with CO2, without ascending aortic clamping.
RESULTS: 23 patients with secundum ASD (in which 2 patients had failed percutaneous ASD closure) and 2 patients with partial anomalous pulmonary venous return (PAPVR) associated with ASD. All defects were closed by artificial patch, continuous suture; anomalous pulmonary veins were drained to the left atrium. No death and surgery-associated complications were reported. Mean operation time and CPB time were 267.1 ± 47.1 (200-360) mins and 155.5 ± 34.2 (100-220) mins, respectively. These patients were extubated within the first 4 hours; draining volume on the first day was less than 80ml. 3 days after the surgery, patients did not need analgesics and be able to return to normal activities 1 week postoperatively.
CONCLUSIONS: Totally endoscopic ASD repair on the beating heart without robotic assistance was safe and effective especially for girls and women.
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