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Experiences in surgical closure of atrial septal defect with anterior mini-thoracotomy approach.

Baharestani B, Rezaei S, Jalili Shahdashti F, Omrani G, Heidarali M - J Cardiovasc Thorac Res (2014)

Bottom Line: One patient re-operated for dehiscence of ASD surgical sutures and there was no reoperation for surgical bleeding or tamponade drainage in these patients.In 74 cases the defect was secundum type, in 2 patients it was sinus venosus type and in one with associated partial Anomalous repair.Anterior thoracotomy approach is safe and may be the surgical technique of choice for secundum ASD repair in all age groups and we can utilize this technique also for more complicated kinds of surgery for instance, sinus venosus type ASD with or without Partial Anomalous Defect.

View Article: PubMed Central - HTML - PubMed

Affiliation: Interventional Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.

ABSTRACT

Introduction: Anterior mini-thoracotomy approach is a good alternative to median sternotomy in Atrial Septal Defect (ASD) repair. Our purpose is to explain the details of our technique and peresent the results.

Methods: Seventy five patients with ASD (52 female and 23 male) were operated with anterior mini-thoracotomy approach in our tertiary center between March 2012 and March 2014. The mean age was 14±10 ranged from 2 to 42 years. Outcomes were defined 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, need for blood transfusion and reoperation.

Results: Mean Cardiopulmonary bypass time was 49.62 minutes (26 to 105 minutes) and mean aortic cross clamp time was 22.29±6.77 minutes (11 to 47 minutes). The mean amount of blood transfusion was 47.49± 62.22 mm (0 to 200 cc) and the mean chest tube drainage after surgery was 80.17 ±121.06 mm (0 to 600 cc). One patient re-operated for dehiscence of ASD surgical sutures and there was no reoperation for surgical bleeding or tamponade drainage in these patients. In 74 cases the defect was secundum type, 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 of choice for secundum ASD repair in all age groups and we can utilize this technique also for more complicated kinds of surgery for instance, sinus venosus type ASD with or without Partial Anomalous Defect.

No MeSH data available.


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Mentions: The incision is single anterior thoracotomy and we perform this kind of cannulation for all patients from 12 months (6 kg) child with a narrow femoral artery and vein to a 100 kg weighed 40 years old lady with very bad femoral exposure. After the systemic administration of the heparin, cannulation of ascending aorta with downward traction of aorta by a simple clump superior vena cava after expose it above the reflection of pericardium and right atrium near inferior vena can be done. We used to use minimally invasive instruments, although simple instruments are enough for use. We generally cannulate ascending aorta directly by 10 to 18 French Edwards Life Science Fem Flex Femoral Arterial Cannula depending on patient’s weight (Figure 1).


Experiences in surgical closure of atrial septal defect with anterior mini-thoracotomy approach.

Baharestani B, Rezaei S, Jalili Shahdashti F, Omrani G, Heidarali M - J Cardiovasc Thorac Res (2014)

© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4195969&req=5

Mentions: The incision is single anterior thoracotomy and we perform this kind of cannulation for all patients from 12 months (6 kg) child with a narrow femoral artery and vein to a 100 kg weighed 40 years old lady with very bad femoral exposure. After the systemic administration of the heparin, cannulation of ascending aorta with downward traction of aorta by a simple clump superior vena cava after expose it above the reflection of pericardium and right atrium near inferior vena can be done. We used to use minimally invasive instruments, although simple instruments are enough for use. We generally cannulate ascending aorta directly by 10 to 18 French Edwards Life Science Fem Flex Femoral Arterial Cannula depending on patient’s weight (Figure 1).

Bottom Line: One patient re-operated for dehiscence of ASD surgical sutures and there was no reoperation for surgical bleeding or tamponade drainage in these patients.In 74 cases the defect was secundum type, in 2 patients it was sinus venosus type and in one with associated partial Anomalous repair.Anterior thoracotomy approach is safe and may be the surgical technique of choice for secundum ASD repair in all age groups and we can utilize this technique also for more complicated kinds of surgery for instance, sinus venosus type ASD with or without Partial Anomalous Defect.

View Article: PubMed Central - HTML - PubMed

Affiliation: Interventional Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.

ABSTRACT

Introduction: Anterior mini-thoracotomy approach is a good alternative to median sternotomy in Atrial Septal Defect (ASD) repair. Our purpose is to explain the details of our technique and peresent the results.

Methods: Seventy five patients with ASD (52 female and 23 male) were operated with anterior mini-thoracotomy approach in our tertiary center between March 2012 and March 2014. The mean age was 14±10 ranged from 2 to 42 years. Outcomes were defined 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, need for blood transfusion and reoperation.

Results: Mean Cardiopulmonary bypass time was 49.62 minutes (26 to 105 minutes) and mean aortic cross clamp time was 22.29±6.77 minutes (11 to 47 minutes). The mean amount of blood transfusion was 47.49± 62.22 mm (0 to 200 cc) and the mean chest tube drainage after surgery was 80.17 ±121.06 mm (0 to 600 cc). One patient re-operated for dehiscence of ASD surgical sutures and there was no reoperation for surgical bleeding or tamponade drainage in these patients. In 74 cases the defect was secundum type, 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 of choice for secundum ASD repair in all age groups and we can utilize this technique also for more complicated kinds of surgery for instance, sinus venosus type ASD with or without Partial Anomalous Defect.

No MeSH data available.


Related in: MedlinePlus