Outcomes Of Minimally Invasive Versus Conventional Arial Septal Defect Repair Single Centre Experience
Bayan Alshaikh, Walid Abukhudair, Khalid Elsheaty.
KFAFH, Jeddah, Saudi Arabia
Background Minimally Invasive Atrial septal defect closure has cosmetic advantage over conventional approach and it is becoming the preferred approach for our patients. We compared clinical outcomes of adult patients undergoing ASD repair via a minimally invasive approach (MIASD) versus conventional Sternotomy.
Methods We retrospectively reviewed the clinical outcomes of consecutive patients who underwent ASD repair ± concomitant procedure at our institution between 2004 and 2017. We compared in-hospital mortality and postoperative complications between patients who underwent MIASD and those who underwent conventional sternotomy.
Results During the study period, 55 consecutive adult patients underwent ASD closure at our institution: 26 in the MISAD group and 29 in the sternotomy group. Patients characteristics were comparable only for HTN which was significantly higher in sternotomy gp (0% vs 20.7% ,P=0.014 ). 11% had combined procedure in the MIASD while 55% in the sternotomy group. Intra-operatively CBP time was comparable (MIASD 94± 30 min vs sternotomy 92 ± 50 min ,P=0.80) cross clamp time (MIASD 56 ± 10 min vs sternotomy 60 ± 30 min,P=0.12). We didn't have any hospital mortality in both groups. There were no significant differences in any postoperative complications. Postoperative blood transfusion had no difference statistically (15% MIASD vs 38% sternotomy ,P=0.061). Mean intensive care unit stay showed no difference (MIASD 2.65 ± 1.41 vs sternotomy 3.2 ± 2.28 ,P=0.29) but hospital length of stays was significantly lower in MIASD (MIASD 7.03 ± 1.85 vs sternotomy 9.75 ± 5.08 ,P=0.015).
Conclusion Repair of ASD can be safely performed via Minimally invasive approach with comparable outcomes to conventional sternotomy and a trend toward a lower length of stay in the MIASD along with an increase in patients satisfaction in term of cosmoses.
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