Minimally Invasive Repair Of Cor Triatriatum: How I Do It
Paola K. Montanhesi, Aly Ghoneim, Junichi Shimamura, Ali Hage, Satoru Fujii, Aaron Grant, Ivan Iglesias, Michael A. W. Chu.
University Hospital, London Health Sciences Centre, London, ON, Canada.
BACKGROUND: Cor Triatriatum is a rare condition characterized by an anomalous fenestrated fibromuscular membrane that divides one of the atria into two chambers. Surgical resection of the membrane is traditionally performed through median sternotomy. However, we believe that minimally invasive options are feasible and safe alternatives in suitable patients.
METHODS: We present a video showing variations of endoscopic minimally invasive techniques used for surgical repair of Cor Triatriatum and associated conditions in our institution.
RESULTS: The presenting video is a compilation of preoperative assessment, multimodal imaging analysis, surgical setup, intraoperative findings, postoperative results and follow up of patients submitted to minimally invasive repair of Cor Triatriatum through inframammary and periareolar approaches. Associated heart conditions such as Atrial Septal Defect, Mitral or Tricuspid valve disease, and Atrial Fibrillation may also be addressed with these techniques. Minimally invasive approaches may offer a number of potential benefits, including faster recovery, reduced hospitalization time, and more cosmetically appealing results when compared to conventional median sternotomy. Moreover, it has been demonstrated that the periareolar technique provides excellent surgical access to the heart with improved esthetic results without compromising nipple and areolar function.
CONCLUSIONS: Minimally invasive repair of Cor Triatriatum is effective and beneficial and should be considered in selected patients.
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