Minimally invasive surgery for congenital heart defects in paediatric patients.
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.
Tiete
A R
AR
Department of Cardiac Surgery, University Hospital Grosshadern, Munich, Germany. atiete@hch.med.uni-muenchen.de
Sachweh
J S
JS
Kozlik-Feldmann
R
R
Netz
H
H
Reichart
B
B
Daebritz
S H
SH
D000293:Adolescent; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006344:Heart Septal Defects, Atrial / Q000601:surgery; D006345:Heart Septal Defects, Ventricular / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D013249:Sternum / Q000601:surgery; D013771:Tetralogy of Fallot / Q000601:surgery; D013908:Thoracotomy / Q000379:methods