Right or left anterolateral minithoracotomy for repair of congenital ventricular septal defects in adult patients.
For most patients who present with ventricular septal defects (VSDs) in adulthood, the major concern is not the mortality or morbidity associated with repair surgery, but rather cosmetic problems arising from surgical scarring as a result of median sternotomy. From March 2005 to August 2008, nine patients (M:F=1:8) underwent repair of congenital VSD using right (n=7) or left (n=2) anterolateral minithoracotomy. We compared the perioperative data of these patients with that of the patients (n=8) who underwent VSD repair using median sternotomy during the same period. VSDs were of the perimembranous (n=6), subarterial (n=1), muscular inlet (n=1), and muscular outlet (n=1) type in minithoracotomy group. There was no in-hospital mortality in both groups. Mean cardiopulmonary bypass (CPB) time in minithoracotomy group was longer than that of sternotomy group (98.0+/-23.7 min vs. 68.5+/-13.3 min, P=0.011), but aorta cross-clamping (ACC) time was not different (45.9+/-20.0 min in minithoracotomy group vs. 40.5+/-12.1 min in sternotomy group) (P=0.481). There were no postoperative complications related to surgery or peripheral cannulation. The mean hospital stay was 3.6 days in minithoracotomy group and 6.1 days in sternotomy group, respectively (P=0.004). Minimally invasive cardiac surgery using minithoracotomy with peripheral cannulation can be safely applied to adult VSD patients irrespective of VSD type.
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, College of Medicine, University of Ulsan, 388-1 Poongnap2-dong, Songpa-gu, Seoul, 138-736, South Korea.
Sung-Ho
SH
Jung
Hyung
H
Gon Je
Suk Jung
SJ
Choo
Tae-Jin
TJ
Yun
Cheol Hyun
CH
Chung
Jae Won
JW
Lee
D000293:Adolescent; D000328:Adult; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D002315:Cardiopulmonary Bypass; D002921:Cicatrix / Q000209:etiology / Q000517:prevention & control; D003250:Constriction; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D056346:Sternotomy / Q000009:adverse effects; D013908:Thoracotomy / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult