Minimally Invasive Cardiac Surgery versus Conventional Median Sternotomy for Atrial Septal Defect Closure
Background: Median sternotomy is the standard approach for atrial septal defect (ASD) closure. However, minimally invasive cardiac surgery (MICS) has been introduced at many centers in adult/grown-up congenital heart patients. We retrospectively reviewed the results of right anterolateral thoracot...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society for Thoracic and Cardiovascular Surgery
2016-12-01
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| Series: | Korean Journal of Thoracic and Cardiovascular Surgery |
| Subjects: | |
| Online Access: | http://www.kjtcvs.org/journal/download_pdf.php?doi=10.5090/kjtcs.2016.49.6.421 |
| Summary: | Background: Median sternotomy is the standard approach for atrial septal defect (ASD) closure. However,
minimally invasive cardiac surgery (MICS) has been introduced at many centers in adult/grown-up congenital
heart patients. We retrospectively reviewed the results of right anterolateral thoracotomy compared with conventional
median sternotomy (CMS) for ASD closure at Seoul National University Hospital. Methods: We retrospectively
analyzed 60 adult patients who underwent isolated ASD closure from January 2004 to December
2013 (42 in the CMS group, 18 in the MICS group). Preoperative, operative, and postoperative data were
collected and compared between the 2 groups. Results: The MICS group was younger (44.6 years vs. 32.4
years, p=0.002) and included more females (66.7% vs. 94.4%, p=0.025) than the CMS group. Operation time
(188.4 minutes vs. 286.7 minutes, p＜0.001), cardiopulmonary bypass time (72.7 minutes vs. 125.8 minutes,
p＜0.001), and aortic cross-clamp time (25.5 minutes vs. 45.6 minutes, p＜0.001) were significantly longer in
the MICS group. However, there were no significant differences in morbidity and mortality between groups.
Only chest tube drainage in the first 24 hours (627.1 mL vs. 306.1 mL, p＜0.001) exhibited a significant
difference. Conclusion: MICS via right anterolateral thoracotomy is an alternative choice for ASD closure. The
results demonstrated similar morbidity and mortality between groups, and favored MICS in chest tube drainage
in the first 24 hours. |
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| ISSN: | 2233-601X 2093-6516 |