Minimally Invasive Cardiac Surgical Techniques in the Closure of Ventricular Septal Defect: An Alternative Approach

Lin, Pyng Jing; Chen, Chang; Chu, Jaw‐Ji; Liu, Huiping; Tsai, Feng‐Chun; Su, Wen‐Jen; Yang, Min-Wen; Tan, Peter

doi:10.1016/s0003-4975(97)01109-0

Cited by 48 publications

(34 citation statements)

References 18 publications

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“…It has recently been applied to a variety of cardiac lesions, including VSD closure in patients older than 3 years [43]. The surgery is done using femorofemoral cardiopulmonary bypass and a left anterior minithoracotomy with video-assisted endoscopy.…”

Section: Other Therapies/considerationsmentioning

confidence: 99%

Ventricular septal defect

1999

Curr Treat Options Cardio Med

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Ventricular septal defects (VSDs) are the most common congenital heart malformations seen in children. Because spontaneous closure occurs frequently, patients with small VSDs should be followed clinically with no limitations except endocarditis prophylaxis. Surgical closure is recommended for only small defects with significant associated lesions such as aortic regurgitation, aortic valve prolapse, right or left ventricular outflow obstruction, tricuspid regurgitation, left ventricle to right atrial shunt, or recurrent endocarditis. Enlarging left ventricular size or deteriorating left ventricular function would also be an indication for surgical repair. Moderate and large VSDs in infancy often require treatment of congestive heart failure with diuretics, digitalis, and afterload reduction. Surgical closure before 9 months of age is indicated for large VSDs and by 2 years of age for moderate shunts to prevent pulmonary vascular obstructive disease and the consequences of long-standing volume overload. Device closure of VSD is still in the investigational stage but holds promise for treatment of apical or multiple muscular VSDs.

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Section: Other Therapies/considerationsmentioning

confidence: 99%

Ventricular septal defect

1999

Curr Treat Options Cardio Med

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“…Since minimally invasive techniques in congenital heart surgery have evolved over the past few years, thoracoscopic approach and partial sternotomy comprise the majority of technical modifications. [3][4][5][6][7][8][9] The rationale for the use of minimally invasive techniques is based on the reduction of skin and skeletal trauma, decrease in pain and discomfort, and decrease in the length of recovery and medical expenses. In addition, cosmetic outcome in pediatric patients may be more important than that in adult patients.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, Lin and associates reported the efficacy of left anterior mini-thoracotomy to close subarterial VSD. 6 However, their techniques require endoscopic instrumentation, femorofemoral cardiopulmonary bypass, moderate hypothermia and transventricular approach. Since major technical modifications or the use of particular instrumentation did not conform with our intent, we selected the lower partial sternotomy.…”

Section: Discussionmentioning

confidence: 99%

“…In general, thoracoscopic approach or partial sternotomy has been employed in the majority of reported techniques. [3][4][5][6][7][8][9] Since July 1997, we have employed a lower partial sternotomy as a minimal access for the repair of atrial septal defect (ASD), ventricular septal defect (VSD) and double chambered right ventricle. In the transpulmonary repair of subarterial VSD, it is often difficult to obtain adequate exposure of the pulmonary artery with this technique.…”

Section: Feasibility Of Transpulmonary Approachmentioning

confidence: 99%

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Partial median sternotomy as a minimal access for the closure of subarterial ventricular septal defect

Murashita

Hatta

Miyatake

et al. 1999

Jpn J Thorac Caridovasc Surg

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“…However, the conventional surgery always accompanies by long midline or thoracotomy skin incisions, postoperative pain and poor cosmetic effects. Occasionally, mediastinitis and osteomyelitis may make the repair of VSD troublesome [2]. In the past few years, interventional occlusion and minimally invasive cardiac surgery have gained popularity in the treatment of VSDs [3, 4].…”

Section: Introductionmentioning

confidence: 99%

Minimally access via left anterior mini-thoracotomy for repair of adult subarterial ventricular septal defects

Liao

Long

Zhu

et al. 2017

J Cardiothorac Surg

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BackgroundMinimally invasive cardiac surgical techniques are increasingly applied in the treatment and management of a variety of adult ventricular septal defects (VSDs). However, repair of adult subarterial VSDs via left anterior mini-thoracotomy is rarely reported. The present study aimed to determine the feasibility and safety of the left anterior mini-thoracotomy for the repair of adult subarterial VSDs.MethodsTwenty-seven adult patients underwent repair of subarterial VSDs via left anterior mini-thoracotomy. The approach includes two options for skin incision access, longitudinal and transverse skin incisions. The skin incision length was 4.1–6.1 cm (mean, 5.1 ± 0.6 cm). The closure of the VSDs was obtained through the main pulmonary artery under direct visualization.ResultsSuccessful repair of the defects was achieved in all the patients. No patients died or converted to median sternotomy. Average durations of cardiopulmonary bypass (CPB) and aortic cross-clamp were 102.5 ± 13.6 min (range, 85–127 min) and 54.6 ± 6.9 min (range, 45–66 min), respectively. No patients required blood transfusion. The average postoperative hospital stay was 5.1 ± 0.7 days (range, 4–6 days). There were no postoperative complications related to the operative procedures or peripheral cannulation. During the follow-up of 5.4–32.3 months, no patients were found to have residual shunt, wound infections, pericardial effusion, neurologic or other complications.ConclusionOur experiences demonstrate that minimally invasive cardiac surgical technique via left anterior mini-thoracotomy can be served as a novel, feasible and safe alternative for the repair of adult subarterial VSDs.

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Minimally Invasive Cardiac Surgical Techniques in the Closure of Ventricular Septal Defect: An Alternative Approach

Cited by 48 publications

References 18 publications

Ventricular septal defect

Ventricular septal defect

Partial median sternotomy as a minimal access for the closure of subarterial ventricular septal defect

Minimally access via left anterior mini-thoracotomy for repair of adult subarterial ventricular septal defects

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