Outcome Of Minimal Invasive Approach For Intracardiac Repair Of Tetralogy Of Fallot Patients
CHIRAG DOSHI, MANISH K. HINDUJA.
UNMICRC, AHMEDABAD, India.
OBJECTIVE: Median sternotomy has been the standard approach for intracardiac repair of patients with tetralogy of fallot. In the era of minimal invasive surgery, left anterior thoracotomy was assessed as an alternative approach for the same procedure.
METHODS: From January 2014 to October 2016, 26 patients with tetralogy of fallot underwent intracardiac repair via a short incision left anterior thoracotomy and minimal invasive cannulation. 16 patients were children and 10 were adult. The average age was 7.4 +/- 2.8 years (2 - 32 years). The average weight was 18.6 +/- 4.6 kg(10 - 67 kg). Patients were selected based on their favourable surgical anatomy and patients with associated cardiac lesions were excluded. Skin incisions were as long as 5 cm. Intraoperative and post operative parameters were studied.Patients were followed up postoperatively for one year and outcomes measuredclinically as well as echocardiographically.
RESULTS: Mean CPB time was 88 min (70-134 min). 10 patients were extubated within 2 hours of surgery. Cosmetic results were very good. There was one mortality due to intractable ventricular arrhythmia. Post operative hemodynamics, need for inotropic support, drain output and ICU stay were similar to patients routinely operated via median sternotomy. on follow up none of the patients were found to have clinically significant morbidity. All patients had acceptable post opertative echocardiiographic reports.
CONCLUSIONS: Intracardiac repair for tetralogy of fallot through left anterior thoracotomy is a safe, effective and cosmetically better alternative to same surgery via median sternotomy.
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