International Society For Minimally Invasive Cardiothoracic Surgery

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Totally Endoscopic Tricuspid Ring Annuloplasty On Beating Hearts In Combination With Atrial Septal Defect Repair: Feasible Technique
Huy Q. Dang, Ngoc M. Nguyen.
Hanoi Heart Hospital, Hanoi, Viet Nam.

Objectives: To investigate the effectivity and safety of totally endoscopic tricuspid ring annuloplasty technique on beating hearts in combination with atrial septal defect (ASD) repair. Methods: Twenty-four patients (39-71 years, mean 52.2 12.3) underwent ASD closure and tricuspid ring annuloplasty on beating hearts by a totally endoscopic approach. All of them had moderate to severe tricuspid valve regurgitation (TVR) with mean pulmonary artery pressure (PAP) was 61.8 10.89 mmHg. Cardiopulmonary bypass (CPB) was achieved peripherally. Three 5-mm trocars and one 12-mm trocar were used; only the superior vena cava is snared, filling the pleural and pericardial cavities with CO2. Results: Tricuspid ring placement was successful in all cases. No extension of the incision was needed. Mean bypass time was 90.2 12.04 min. After surgery, there were 15 cases with non-trivial TVR and 9 cases with mild TVR. Postoperative mean PAP was 28.4 12.19 mmHg. No arrhythmia or AV block was recorded. Conclusions: Tricuspid ring annuloplasty in non-robotic totally endoscopic ASD closure on beating hearts is a safe and efficient technique.

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