Abstract
ObjectiveTo evaluate the effectiveness and safety of right anterolateral mini-thoracotomy without inferior vena cava (IVC) cannulation for closing atrial septal defect (ASD) in small children. MethodsFrom February 2016 to August 2017, 10 patients (the mean age was 18.5 ± 10.1 months and the mean weight was 8.3 ± 2.1 kg) underwent ASD closure via right anterolateral mini-thoracotomy. The superior vena cava cannula was placed through the right internal jugular vein. A 3–4 cm incision was made on the right chest. The pleural and pericardial cavities were filled with CO2 and the heart was beating during the surgery. Blood returned from IVC was drained by a right heart sucker. All ASDs were closed using artificial patch, continuous suture. Mean follow-up was 18 months (range, 15–22 months). ResultsNo post-operative complications or deaths occurred. Mean operation time and mean cardiopulmonary bypass time were 140.5 ± 27.8 min and 50.3 ± 16.5 min, respectively. These patients were extubated within the first 6 h. The intensive care unit stay time and the post-operative hospital stay time were 19.6 ± 2.6 h and 7.1 ± 1.2 days, respectively. Follow-up transthoracic echocardiography showed no residual shunts or lung atelectasis. ConclusionsThe right anterolateral mini-thoracotomy without IVC cannulation is feasible for repairing ASD in small children. This technique is effective and safe and can be used as a therapeutic option for ASD.
Highlights
Atrial septal defect (ASD) is one of the most common congenital heart disease [1], and sometimes needs to be closed during childhood
We reported on using transthoracic aortic cannulation for totally endoscopic ASD repair in a 10.5-kgboy [4], but it seems impossible for smaller children
We report our first experience in repairing ASD in small children via right anterolateral mini-thoracotomy with a new method of setting up cannulae
Summary
To evaluate the effectiveness and safety of right anterolateral mini-thoracotomy without inferior vena cava (IVC) cannulation for closing atrial septal defect (ASD) in small children. Mean operation time and mean cardiopulmonary bypass time were 140.5 ± 27.8 min and 50.3 ± 16.5 min, respectively. These patients were extubated within the first 6 h. CONCLUSIONS: The right anterolateral mini-thoracotomy without IVC cannulation is feasible for repairing ASD in small children. This technique is effective and safe and can be used as a therapeutic option for ASD
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