Repair of simple congenital cardiac defects via lower ministernotomy, using standard instruments

Abstract

In the current scenario the costs of performing minimally invasive cardiac surgery are very high primarily due to the high cost of hardware used, limiting its widespread usage especially in a developing country like ours. The aim of our study was to test the feasibility and safety of performing minimally invasive surgery to repair simple congenital cardiac defects using standard equipment. From July 2011 to March 2012, 59 patients, weighing between 7 kg to 32 kg underwent closure of their defects via lower ministernotomy. Forty six cases were Ostium Secundum Atrial Septal Defect (OSASD), four cases had OSASD with Valvar Pulmonary Stenosis (PS), five cases of moderate Ventricular Septal Defect (VSD), three cases of Sinus Venosus Atrial Septal Defect (SVASD) and one case of Partial AtrioVentricular Canal Defect (PAVCD). All patients underwent central canulation of aorta and vena cava. Standard cannula and instruments were used during the procedure. The length of the postoperative scar measured ranged from 3.5 to 8 cm. One SVASD was converted to complete sternotomy because of high drainage of the Partial Anomalous Partial Venous Connection (PAPVC). None of the patients had any emergency conversion, re-exploration or neurological side effects. One patient had a tiny residual VSD and another patient had a pericardial effusion that required drainage. Repair of most simple congenital cardiac defects can be safely performed through a lower ministernotomy approach. The procedure resulted in a cosmetically appealing scar and decreased patient morbidity without using any special expensive instruments.