Open AccessExperience of Minimal Invasive Cardiac Surgery for repair of Atrial Septal Defects- A Single Center Study
Author(s) -
Mohammad Rokonujjaman,
Naveen Sk,
Shaheedul Islam,
Nusrat Ghafoor,
Syed Tanvir Ahmad,
Abdullah Al Shoeb,
Atiqur Rahman,
Ibrahim Khalilullah,
Sirajul Islam,
Nowshin Siraj,
Siba Pada Roy,
Pradip Kumar Saha
Publication year - 2021
Publication title -
cardiovascular journal
Language(s) - English
Resource type - Journals
eISSN - 2309-6357
pISSN - 2071-0917
DOI - 10.3329/cardio.v14i1.55372
Subject(s) - medicine , mechanical ventilation , surgery , intensive care unit , median sternotomy , cardiopulmonary bypass , single center , anesthesia , cardiac surgery
Background: Atrial Septal Defects (ASD) can be closed surgically using conventional midline sternotomy or minimal invasive technique. This study was done to evaluate the outcome and safety of the minimal invasive cardiac surgical (MICS) approach using right vertical infra axillary incision (RVAI) for the repair of ASD.Methods: We performed a prospective observational cross-sectional analysis on 50 patients who were diagnosed as ASD of various types and not amenable to device closure. Their surgery was done RVAI using central cardiopulmonary bypass. Outcome of the study was evaluated using the following variables: length of the incision, satisfaction of patients, mortality, infection of surgical site, blood transfusion, duration of total operation, intensive care unit (ICU) stay, mechanical ventilation, hospital stay and aortic occlusion. Operations were done between December 2013 to December 2020. All the recruited patients were treated through RVAI as per patient’s choice.Results: Mean age was 11.4± 6.4 years. 18(36%) were male and 32(64%) were female. Body weight ranged from 10 to 65 kg. Mean length of incision was 6.2±0.8 cm. Mean aortic occlusion time was 42±14 min. ASD closed directly, using autologous treated pericardial patch or dacron patch. Mean total operation time was 4.08±0.6 hours and mean mechanical ventilation time was 8.3±5 hours. Average ICU stay was 35.6±6 hours and total hospital stay was 7.2±0.9 days. There was no significant blood loss. Only 10 patients required intravenous (IV) analgesics in the post-operative period. One patient required re-exploration, one conversion to median sternotomy and one suffered from superficial skin infection. There were no operative or late mortalities. Patient satisfaction was excellent.Conclusions: MICS technique using RVAI for surgical repair of ASD revealed a safe procedure and could be performed with excellent cosmetic and clinical outcomes. It provided a good alternative to the standard median sternotomy.Cardiovasc j 2021; 14(1): 37-43