Outcomes of Totally Endoscopic Atrial Septal Defect Closure Using a Glutaraldehyde-Treated Autologous Pericardial Patch.
We evaluated the outcomes of totally endoscopic minimally invasive surgery for atrial septal defect (ASD) using a glutaraldehyde-treated autologous pericardial patch in the transcatheter interventional era.



We retrospectively reviewed 37 consecutive patients who underwent totally endoscopic ASD closure with a glutaraldehyde-treated autologous pericardial patch between June 2011 and April 2015. All patients had been deferred from catheter-based intervention for clinical or anatomical reasons. We analyzed operative outcomes and postoperative echocardiographic data. The mean age was 45.7±16.5 years, and 25 patients (67.6%) were women. The mean ratio of pulmonary to systemic flow was 2.4±0.7. Six patients (16.2%) underwent concomitant tricuspid valve repair, and 3 patients (8.1%) underwent concomitant atrial fibrillation surgery. There were no operative deaths, and the median length of hospital stay was 5 days. Postoperative echocardiography revealed trivial residual shunt in 1 patient. During the follow-up period, there were no re-interventions for ASD or readmission for heart failure. Follow-up echocardiography revealed no recurrent shunt or calcification of the autologous pericardial patch.



Totally endoscopic ASD closure with a glutaraldehyde-treated autologous pericardial patch demonstrated excellent outcomes. It is a useful option for patients with unfavorable anatomy or other reasons excluding transcatheter intervention.
Department of Cardiovascular Surgery, Sakakibara Heart Institute.
Hidefumi
H
Nishida
Department of Cardiovascular Surgery, Tokyo Bay Urayasu-Ichikawa Medical Center.
Daisuke
D
Nakatsuka
Department of Cardiovascular Surgery, Tokyo Bay Urayasu-Ichikawa Medical Center.
Yuji
Y
Kawano
Department of Cardiovascular Surgery, Tokyo Bay Urayasu-Ichikawa Medical Center.
Nobuhiko
N
Hiraiwa
Department of Cardiovascular Surgery, Sakakibara Heart Institute.
Shuichiro
S
Takanashi
Department of Cardiovascular Surgery, Sakakibara Heart Institute.|Department of Cardiovascular Surgery, Tokyo Bay Urayasu-Ichikawa Medical Center.
Minoru
M
Tabata
D000328:Adult; D064592:Autografts; D006348:Cardiac Surgical Procedures / Q000379:methods; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005976:Glutaral / Q000627:therapeutic use*; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010496:Pericardium / Q000637:transplantation*; D012189:Retrospective Studies; D016378:Tissue Transplantation / Q000379:methods; D016896:Treatment Outcome
D005976:Glutaral
Congenital heart disease; Pericardium; Surgery