101 bệnh nhi được chẩn đoán tim bẩm sinh dạng một tâm thất đã phẫu thuật Fontan tại trung tâm tim mạch – Bệnh viện E từ 8/2012 đến tháng 12/2018. Z-score của chiều cao, cân nặng trước phẫu thuật lần lượt là -1,28  1,09 và -1,76 ± 1,61 (SD), được cải thiện rõ rệt sau phẫu thuật với Zscore của chiều cao, cân nặng theo tuổi tương ứng là -0,87  1,06 và -0,85 ± 1,14 (SD), p < 0,05. Các yếu tố ảnh hưởng đến tăng trưởng của trẻ bao gồm phẫu thuật sớm trước 48 tháng tuổi, đặc điểm tâm thất hệ thống, tình trạng hở van nhĩ thất. Bệnh nhân sau phẫu thuật Fontan hầu hết đã bắt kịp tăng trưởng. Tuổi phẫu thuật và tình trạng hở van nhĩ thất có liên quan chẽ với sự tăng trưởng cân nặng và chiều cao của trẻ, trong khi dạng tâm thất hệ thống dường như không liên quan đến tăng trưởng sau phẫu thuật.

Introduction: Atrial Septal Defect is the most common congenital heart disease. Minimally invasive cardiac surgery is being perfomed routinely at several cardiovascular centers in Vietnam. At E Cardiovascular Center, from 2016 to 2019, we performed total endoscopic closure for atrial septal defect in children using 4 trocars. From 2020 to present, we have reduced the number of trocars to three. This report was to evaluate the effectiveness and early results of total endoscopic closure with 3 trocars for atrial septal defect in children. Method: Twelve children underwent ASD closure from 1/2020 to 5/2021, with mean age of 7.7 years old (range from 2.5 to 11); mean weight was 20.8 kilograms (range from 12 to 40). All the patients underwent the operation with peripheral cardiopulmonary bypass (CPB). Result: The mean peripheral circulation time was 70 minutes (range from 56 to100 minutes) on beating hearts. There were 8 cases with patch-closure and 4 cases with direct-closure. After operations, we reexamined by echocardiography, the atrial septal defects were closed completely with no residual shunt, the common femoral arteries at the cannula position were normal and no stenosis were present. Conclusion: Totally endoscopic closure for ASD on beating hearts with 3 trocars is save with a very good short-term results.

Objectives: To describe the procedure of totally endoscopic closure of ventricular septal defect (VSD) without robotic assistance. Methods: Totally endoscopic VSD closure was performed in 17 patiens (12 childrens and 5adults). The age was 8,5 year olds ( from 3 to 46), and the body weight was 31,2 kg (from 10 to 57). 16 patients were diagnosed with peri-membranous VSD and 1 infundibular VSD, in which 5 patients had right ventricular outflow tract stenosis. We used three 5mm-trocarts  and one 12mm-trocart in the right chest. Using pperipheral cannulation for ccardiopulmonary bypass, superior vena caval occlusion, Chitwood aortic clamp, right atriotomy and closing VSD by totally endoscopy without a robotically assisted surgical system. Results: There were no postoperative complications and deaths. cardiopulmonary bypass time and Aortic clamping time were 120 mins and 70 mins respectively. The mean mechanical ventilation time was 1.5 hours. Patients was hospitalized for 5.4 days and could resume normal daily activitive after 1 week. Conclusions: Totally endoscopic closure of ventricular septal defect without robotic assistance is safe and feasible leaving only a small surgical scar with good aesthetics.