Video-assisted thoracoscopic surgery for congenital heart disease.
We report our experience with video-assisted thoracoscopy in the surgical closure of heart septal defects. Nine patients, aged 10 to 26 years, underwent operation for closure of an atrial septal defect; and 3, aged 10 to 22 years, for closure of a ventricular septal defect. Three minithoracotomies with a diameter of 2 to 3 cm were made in the fourth intercostal space of the right parasternum and the fourth and seventh intercostal spaces of the right middle axillary line, respectively. Through the openings and guided by a thoracoscope, a catheter was inserted into the superior vena cava, femorofemoral extracorporeal circulation was built, the aorta was crossclamped, and the myocardium was protected by cold cardioplegia. The right atrium was opened, and the defect was exposed with a traction suture. Primary closure of defects was performed successfully in all patients. The duration of aortic crossclamping and extracorporeal circulation ranged from 11 to 56 minutes and from 50 to 168 minutes, respectively. Postoperatively, cardiac murmur disappeared and echocardiograms showed no residual shunt. Repair of heart septal defects can be completely done with the assistance of video-assisted thoracoscopy, offering a new option with minimal incision.
Yu
Shi Qiang
SQ
Institute of Cardiovascular Surgery Xijing Hospital The Fourth Military Medical University Xian, Shaanxi, People's Republic of China. ysq2002@21cn.com
Cai
Zhen Jie
ZJ
Cheng
Yun Ge
YG
Duan
Da Wei
DW
Xu
Xue Zheng
XZ
Chen
Wen Sheng
WS
Zhou
Gen Xu
GX
D000293:Adolescent; D000328:Adult; D002648:Child; D005112:Extracorporeal Circulation; D005240:Feasibility Studies; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000601:surgery*; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D015203:Reproducibility of Results; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted; D013997:Time Factors; D014463:Ultrasonography