title: Surgical closure of atrial septal defect. Minimally invasive cardiac surgery or median sternotomy?
abstract: BACKGROUND
  Closure of ostium secundum atrial septal defect (ASD) vis median sternotomy (MS) is a simple procedure for most cardiac surgeons. Minimally invasive cardiac surgery (MICS) has recently been applied in the management of intracardiac lesions.
  
  
  METHODS
  We report our experience in surgical closure of isolated ASD via MICS in 60 patients and via MS in 58 patients. There was no difference between these two groups in gender, age, body weight, ratio of systemic to pulmonary blood flow, and pulmonary arterial pressure.
  
  
  RESULTS
  The duration of cardiopulmonary bypass was significantly longer in the MICS group than in the MS group [27 to 126 min (42 +/- 12) and 14 to 158 min (27 +/- 11), respectively; (p < 0.001]. However, the length of incision, incidence of temporary pacemaker wire insertion rate, duration of endotracheal intubation, timing of oral intake, postoperative day drainage amount, incidence of parenteral analgesic injection, postoperative length of stay, and return to normal activity interval were significant shorter and lower in patients of the MICS group than in those of the MS group. All the patients recovered rapidly from the surgery. Follow-up was complete in all patients, with no late complications and no residual shunt.
  
  
  CONCLUSIONS
  Our results suggest that MICS is a good option for surgical closure of ASD.
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei, Taiwan.
authors.forename: C H
authors.initials: CH
authors.lastname: Chang
authors.forename: P J
authors.initials: PJ
authors.lastname: Lin
authors.forename: J J
authors.initials: JJ
authors.lastname: Chu
authors.forename: H P
authors.initials: HP
authors.lastname: Liu
authors.forename: F C
authors.initials: FC
authors.lastname: Tsai
authors.forename: Y Y
authors.initials: YY
authors.lastname: Chung
authors.forename: C C
authors.initials: CC
authors.lastname: Kung
authors.forename: F C
authors.initials: FC
authors.lastname: Lin
authors.forename: C W
authors.initials: CW
authors.lastname: Chiang
authors.forename: W J
authors.initials: WJ
authors.lastname: Su
authors.forename: M W
authors.initials: MW
authors.lastname: Yang
authors.forename: P P
authors.initials: PP
authors.lastname: Tan
mesh_terms: D000293:Adolescent; D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D012189:Retrospective Studies; D013249:Sternum / Q000601:surgery*; D013524:Surgical Flaps; D013908:Thoracotomy / Q000379:methods*