According to the mid-term follow-up results, PVDC has similar efficacy to CA for VSD closure. The off-pump PVDC technique reduces blood product transfusion and the procedural time and minimizes surgical trauma while providing excellent cosmetic results.

The described off-pump approach showed excellent results. It offers such advantages as avoidance of the morbidity associated with cardiopulmonary bypass, significantly shorter hospital stay and therefore reduced costs, and a cosmetic advantage.

OBJECTIVES This study aimed to compare vacuum-assisted closure therapy (VAC) and closed irrigation drainage therapy (CID) for deep sternal wound infection treatment in infants. METHODS From January 2008 to March 2018, 69 patients (1.73%) had deep sternal wound infection. They were divided into 2 groups: patients treated with VAC therapy (VAC group, 29 patients) and those treated with CID therapy (CID group, 40 patients). After performing a propensity score analysis (1:1) for the entire sample, 16 patients receiving VAC therapy were matched with 16 patients receiving CID therapy. RESULTS No significant difference was noted between both groups regarding age [d = 0.045; 95% confidence interval (CI) 0.99–1.07], gender (d = 0.001; 95% CI 0.22–4.45), weight (d = 0.011; 95% CI 0.73–1.35), body surface area (d = −0.023; 95% CI 0.01–5733.08), cardiopulmonary bypass (d = 0; 95% CI 0.16–5.90) and open chest duration (d = −0.112; 95% CI 0.31–5.16). Five patients died in the CID group (31.25%) during hospital stay, and there were no deaths in the VAC group (P = 0.024). Recurrence of mediastinitis occurred in 1 patient (6.25%) from the VAC group and in 6 patients (37.5%) from the CID group (P = 0.037). The multivariable regression analysis revealed that the CID method was the only risk factor for remediastinitis (odds ratio 17.3; 95% CI 1.04–286.75; P = 0.046). CONCLUSIONS Use of VAC therapy in infants with deep sternal wound infection was associated with a substantial decrease in the mortality rate and duration of therapy compared with CID technique. The CID technique was an independent risk factor for recurrence of mediastinitis.

No abstract

Currently, minimally invasive cardiac surgery has found widespread use even in congenital heart surgery. The number of defects, which can be corrected through a small incision or totally endoscopic, is on the rise. Nowadays, surgeons can repair atrial septal defect, ventricular septal defect, patent ductus arteriosus and other congenital heart defects using minimally invasive techniques. In this paper, we report 21 cases of successful repair of supracardiac partial anomalous right upper and middle pulmonary venous connection, using the Warden procedure. It was performed in children through the right-sided midaxillary thoracotomy with direct cardiopulmonary bypass cannulation and induction of ventricular fibrillation. There were no operative or early postoperative deaths or complications. All patients were in sinus rhythm at discharge. According to echocardiography, there were no cases of early SVC or pulmonary veins narrowing. The Warden procedure can be performed safely and efficiently using the minimally invasive cardiac surgery.