Experiences in Surgical Closure of Atrial Septal Defect with Anterior Mini-Thoracotomy Approach

Abstract

Introduction: The surgeons and their patients are now seeing the benefits and extendedpossibilities of minimally invasive cardiac surgery. Anterior mini-thoracotomy approach is agood alternative to median sternotomy since it reduces operative trauma, accelerates recoveryand yields a better cosmetic outcome. Our purpose is to explain the details of our technique andmanifest the experience results.Methods: Seventy five patients with secundum Atrial Septal Defect (ASD) (52 female and 23 male)were operated with anterior mini-thoracotomy approach in our tertiary research center betweenMarch 2012 and March 2014. The mean age was 14±10 ranged from 2 to 42 years. Outcomes weredefined according to cardiopulmonary and aortic cross-clump time, intensive care unit stay time,morbidity, mortality, the size of incision, the amount of post-operative bleeding, the amount ofblood transfusion, reoperation and the surgical details.Results: Mean Cardiopulmonary bypass time (CPB time) was 49.62 minutes (from 26 to 105minutes) and mean aortic cross clamp time was 22.29±6.77 minutes (between 11 to 47 minutes).The mean amount of blood transfusion was 47.49± 62.22 mm (ranged 0 to 200 cc) and themean chest tube drainage after surgery was 80.17 ±121.06 mm (ranged 0 to 600 cc). One patientre-operated for dehiscence of ASD surgical sutures and there was no reoperation for surgicalbleeding or tamponade drainage in these patients. In 74 cases the defect was secundum type ASD,in 2 patients it was sinus venosus type and in one with associated partial Anomalous repair.Conclusion: Anterior thoracotomy approach is safe and may be the surgical technique ofchoice for secundum ASD repair in all age groups and we can utilize this technique also formore complicated kinds of surgery for instance, sinus venosus type ASD with or without PartialAnomalous Defect.