title: 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.
authors.affiliation: Department of Cardiac Surgery, University Hospital Grosshadern, Munich, Germany. atiete@hch.med.uni-muenchen.de
authors.forename: A R
authors.initials: AR
authors.lastname: Tiete
authors.forename: J S
authors.initials: JS
authors.lastname: Sachweh
authors.forename: R
authors.initials: R
authors.lastname: Kozlik-Feldmann
authors.forename: H
authors.initials: H
authors.lastname: Netz
authors.forename: B
authors.initials: B
authors.lastname: Reichart
authors.forename: S H
authors.initials: SH
authors.lastname: Daebritz
mesh_terms: 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