Atrial septal defect repair with minithoracotomy using two stage single venous cannula.
OBJECTIVE
Repair of atrial septal defect (ASD) via minimal access has been the preferred method to improve cosmesis and fast rehabilitation. A 2-stage single venous cannula introduced via the femoral route allows better vision of the surgical field and improves surgical acts through a limited incision.


METHODS
From February 1999 to December 2001 a minithoracotomy approach was used for closure of secundum type ASD by using single bicaval venous cannula in 17 adult patients. A 6 to 7 cm anterior minithoracotomy (submammary) approach with femoral arterial and 2-stage single venous cannula were utilized. Defects were closed primarily by running suture in 14 and with a patch in 3 patients.


RESULTS
Calculated flow levels were maintained with a single venous cannula without assisted venous drainage in all patients. The postoperative course was uneventful in all patients except 1 who required revision for bleeding which was done through the same incision. Extension of the thoracotomy or shifting to the classic sternotomy was never required.


CONCLUSIONS
Single venous bicaval cannula allows efficient drainage of both vena cavae and improves the surgical vision and manipulation through the right minithoracotomy. With this technique, repair of ASD can be done safely with good cosmesis.
Demirsoy
E
E
Department of Cardiovascular Surgery, Istanbul Memorial Hospital, Istanbul, Turkey. ergundemirsoy@hotmail.com
Arbatli
H
H
Unal
M
M
Yagan
N
N
Tukenmez
F
F
Sonmez
B
B
D000293:Adolescent; D000328:Adult; D001783:Blood Flow Velocity; D002302:Cardiac Output; D002405:Catheterization, Central Venous / Q000295:instrumentation / Q000379:methods*; D004322:Drainage; D004867:Equipment Design; D005260:Female; D005263:Femoral Artery; D005268:Femoral Vein; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D012086:Reoperation / Q000706:statistics & numerical data; D013249:Sternum / Q000601:surgery; D013536:Suture Techniques; D013908:Thoracotomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D014684:Venae Cavae