Minimally invasive approach for coronary artery fistula correction.
Minimally invasive cardiac surgery has recently become widespread. The aim of this study is to analyse the feasibility of a minimally invasive approach for coronary artery fistula (CAF) correction.



From February 2001 to June 2014, 49 patients in our centre underwent minimally invasive CAF correction without cardiopulmonary bypass (CPB). The mean age was 21.18 ± 11.24 years (range, 5 months to 64 years). Patients with cardiac anomalies who underwent CAF correction and those who underwent CAF via the minimally invasive approach with CPB were excluded.



There were no in-hospital mortalities or conversions to median sternotomy. Subxiphoid incisions (22 cases) and parasternal incisions (20 cases) were the most commonly used approaches for the procedure. The operative time was 67.45 ± 22.69 min (30-125 min). The intubation time was 3.72 ± 1.82 h (2-12 h), and the ICU stay was 9.67 ± 5.43 h (4-24 h). A trivial residual shunt was identified in only 1 patient during the procedure; however, this shunt had disappeared by discharge.



The minimally invasive approach can provide excellent surgical exposure for CAF ligation in select patients. This approach is a safe and cosmetic alternative to conventional treatment and may minimize the length of stay.
Department of Cardiac Surgery, Asia Heart Hospital, Wuhan, China.
Laichun
L
Song
Department of Cardiac Surgery, Asia Heart Hospital, Wuhan, China.
Bo
B
Wang
Department of Cardiac Surgery, Asia Heart Hospital, Wuhan, China.
Jing
J
Jin
Department of Cardiac Surgery, Asia Heart Hospital, Wuhan, China.
Zhengdong
Z
Hua
Department of Cardiac Surgery, Asia Heart Hospital, Wuhan, China.
Huadong
H
Yu
Department of Cardiac Surgery, Asia Heart Hospital, Wuhan, China.
Liang
L
Tao
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D061646:Operative Time; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult
Congenital heart disease; Coronary artery fistula; Minimally invasive surgery