Minimally Invasive Surgery for Congenital Heart Defects in Paediatric Patients

Abstract

Background: In selected cases, minimally-invasive approaches are favoured for the correction of congenital heart defects with regard to better cosmetic results. Methods: Between July 1999 and April 2001, 25 children (9 male; mean age 5.8 ± 4.1 years; mean weight 19.6 ± 12.6 kg) were operated on using minimally invasive approaches. Diagnoses were: ASD (n = 19), VSD (n = 2), ostium primum defect (n = 3) and Tetralogy of Fallot (n = 1). Female patients with ASD underwent a limited right anterolateral thoracotomy. A ministernotomy was chosen in male patients, in patients under 6 months of age, and in patients with malformations other than ASD. Cannulation was always performed via the chest incision. Results: There were no perioperative complications. Mean operation time was 3.23 ± 0.89 h. Twelve patients were extubated immediately after surgery, mean ventilation time in the others was 12.1 ± 11.7 h. Mean ICU stay and hospital stay were 1.5 ± 0.75 days and 8.3 ± 2.2 days, respectively. Follow-up (mean 4.8 ± 4.6 months) was uneventful. Conclusions: Intracardiac repair of some congenital heart defects can be performed safely and effectively via minimally-invasive approaches. Indications are expanding towards more complex defects. Exposure for precise repair is good, additional incisions can be avoided, and cosmetic results have been excellent.

Key words

Congenital heart surgery - Minimally invasive surgery - Ministernotomy - Anterolateral thoracotomy

References

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