Totally Thoracoscopic Surgical Closure of Atrial Septal Defect in Small Children

Feng, Wenquan; Li, Min; Xu, Xuezeng; Shi-ying, YU; Cheng, Zhaoyun; Deng, Chao

doi:10.1016/j.athoracsur.2011.03.033

Cited by 32 publications

(34 citation statements)

References 15 publications

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“…Totally thoracoscopic techniques without the aid of the Da Vinci system in cardiac operation now become a reality with the technological development. Totally thoracoscopic techniques for cardiac surgery only need three small incisions with 1.0-2.5 cm each in length [12]. The techniques avoid the conventional midline sternotomy and change the opinion that a direct vision should be needed in cardiac surgery and also provide a cosmetic cut for patients.…”

Section: Discussionmentioning

confidence: 99%

Totally thoracoscopic surgery for the treatment of atrial septal defect without of the robotic Da Vinci surgical system

Liu

Qiao

et al. 2013

J Cardiothorac Surg

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BackgroundMore and more surgeons and patients focus on the minimally invasive surgical techniques in the 21st century. Totally thoracoscopic operation provides another minimal invasive surgical option for patients with ASD (atrial septal defect). In this study, we reported our experience of 61 patients with atrial septal defect who underwent totally thoracoscopic operation and discussed the feasibility and safety of the new technique.MethodsFrom January 2010 to October 2012, 61 patients with atrial septal defect underwent totally thoracoscopic closure but not traditional median sternotomy surgery. We divided the 61 patients into two groups based on the operation sequence. The data of group A (the first 30 cases) and group B (the last 31 cases). The mean age of the patients was 35.1 ± 12.8 years (range, 6.3 to 63.5 years), and mean weight was 52.7 ± 11.9 kg (range, 30.5 to 80 kg). Mean size of the atrial septal defect was 16.8 ± 11.3 mm (range, 13 to 39 mm) based on the description of the echocardiography.ResultsAll patients underwent totally thoracoscopy successfully, 36 patients with pericardium patch and 25 patients were sutured directly. 7 patients underwent concomitant tricuspid valvuloplasty with Key technique. No death, reoperation or complete atrioventricular block occurred. The mean time of cardiopulmonary bypass was 68.5 ± 19.1 min (range, 31.0 to 153.0 min), the mean time of aortic cross-clamp was 27.2 ± 11.3 min (range, 0.0 to 80.0 min) and the mean time of operation was 149.8 ± 35.7 min (range, 63.0 to 300.0 min). Postoperative mechanical ventilation averaged 4.9 ± 2.5 hours (range, 3.5 to 12.6 hours), and the duration of intensive care unit stay 20.0 ± 4.8 hours (range, 15.5 to 25 hours). The mean volume of blood drainage was 158 ± 38 ml (range, 51 to 800 ml). No death, residual shunt, lung atelectasis or moderate tricuspid regurgitation was found at 3-month follow-up.ConclusionThe totally thoracoscopic operation is feasible and safe for patients with ASD, even with or without tricuspid regurgitation. This technique provides another minimal invasive surgical option for patients with atrial septal defect.

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Section: Discussionmentioning

confidence: 99%

Totally thoracoscopic surgery for the treatment of atrial septal defect without of the robotic Da Vinci surgical system

Liu

Qiao

et al. 2013

J Cardiothorac Surg

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“…In the current era, the surgical management of cardiac pathologies in children is generally made through traditional sternotomy and thoracotomy incisions. Nevertheless, thoracoscopic cardiac surgery has been performed safely as a minimally invasive approach in larger children (15)(16)(17). The feasibility and safety of robotic cardiac surgery under cardiopulmonary bypass has remained limited in children due to technical limitations (7)(8)(9)(10)(18)(19)(20)(21)(22)(23).…”

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confidence: 99%

Totally Endoscopic Robotic‐Assisted Cardiac Surgery in Children

et al. 2018

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Robotic surgery for intracardiac pathologies in children is relatively uncommon. This study presents our initial experience with robotic-assisted cardiac surgery in children. We also present the feasibility and safety of robotic surgery in children. From May 2013 to June 2018, 30 children underwent totally endoscopic robotic atrial septal defect closure (n = 22), right-sided (n = 5) or left-sided (n = 1) partial anomalous pulmonary venous connection repair, tricuspid valve annuloplasty (n = 4), and mitral valve replacement (n = 2, due to Barlow and rheumatic diseases). The mean age of the patients was 16.1 ± 1.1 years (range, 13-17) and the mean weight was 56.7 ± 0.1 kg (range, 42-77). Associated anomalies included left persistent superior vena cava (n = 2) and the absence of innominate vein (n = 1). All procedures were completed uneventfully. Operation time was 4.1 ± 0.6 h. No patient was converted to thoracotomy or sternotomy. Cardiopulmonary bypass and aortic clamping times were 90.6 ± 28.0 (range, 45-136) and 48.6 ± 24.9 (range, 15-94) min, respectively. The mean ventilation time was 3.7 ± 1.2 h and hospital stay time was 3.3 ± 0.7 days. No right phrenic nerve injury, hemorrhage, or blood transfusion were noted. One patient had postoperative pneumothorax, and 1 had supraventricular arrhythmia. Follow-up was a mean of 1.7 years (range, 1-52 months). Patients were healthy and no residual intracardiac defect was observed on echocardiography examinations. There was no operative or follow-up mortality. Robotically assisted cardiac surgery is a feasible and safe approach in selected pediatric patients. In the future, new generation robotic devices may offer an alternative surgical approach in cardiac surgery for younger children with lower body weight.

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“…Some surgeons reported postoperative right atelectasis with the incidence from 2.5% to 7.1% because of one-lung ventilation during surgery. 12,25,26 We chose two-lung ventilation with single-lumen endotracheal tube because 40% of our patients were small children, and this method made CPB time last longer, but it helped prevent postoperative atelectasis. To decrease CPB time, recently, double-lumen endotracheal tube was only used for a young adult patient, and it resulted in 10-minute reduction in CPB time.…”

Section: Discussionmentioning

confidence: 99%

“…[8][9][10][11] There were not many scientific reports on totally endoscopic surgery without robotic assistance for ASD closure, especially in small children. 12,13 We report our first experience in applying totally endoscopic surgery techniques for the treatment of ASD.…”

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confidence: 99%

Totally Endoscopic Cardiac Surgery for Atrial Septal Defect Repair on Beating Heart without Robotic Assistance in 25 Patients

Dang

Nguyen

et al. 2017

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The aim of the study was to investigate the effectivity and safety of totally endoscopic cardiac surgery without robotic assistance for atrial septal defect (ASD) closure on beating hearts. Methods: Twenty-five patients (adults/children: 15/10) underwent ASD closure using nonrobotically assisted totally endoscopic approach on beating heart. 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 CO 2 , and the heart was beating during the surgery. Twentythree patients had isolated secundum ASD (2 of which had severe tricuspid regurgitation) and two patients had ASD combined with partial anomalous pulmonary venous connection. All ASDs were closed using artificial patch, continuous suture; tricuspid regurgitations were repaired and the anomalous pulmonary veins were drained to the left atrium. Results: No postoperative complications or deaths occurred. Mean ± SD operation time and mean cardiopulmonary bypass time were 267.2 ± 44.6 and 156.1 ± 33.6 min, respectively. These patients were extubated within the first 5 hours, and the volume of blood drainage on the first day was less than 80 mL. Four days after surgery, patients did not need analgesics and were able to return to normal activities 1 week postoperatively. Conclusions: Totally endoscopic operation for ASD closure on beating heart is safe, with short recovery period, and surgical scars are of high cosmetic value, especially in a woman and girl.

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Totally Thoracoscopic Surgical Closure of Atrial Septal Defect in Small Children

Cited by 32 publications

References 15 publications

Totally thoracoscopic surgery for the treatment of atrial septal defect without of the robotic Da Vinci surgical system

Totally thoracoscopic surgery for the treatment of atrial septal defect without of the robotic Da Vinci surgical system

Totally Endoscopic Robotic‐Assisted Cardiac Surgery in Children

Totally Endoscopic Cardiac Surgery for Atrial Septal Defect Repair on Beating Heart without Robotic Assistance in 25 Patients

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