Cirugía mínimamente invasiva en niños. Corrección de la comunicación interauricular por vía axilar y submamaria

Gil-Jaurena, Juan-Miguel; Zabala, Juan-Ignacio; Conejo, Lourdes; Cuenca, Victorio; Picazo, Beatriz; Jiménez, Clara; Castillo, Rafael; Ferreiros, Manuel; Mora, Manuel de; Loma, J. Gutiérrez de

doi:10.1016/j.recesp.2010.08.009

Cited by 22 publications

(9 citation statements)

References 24 publications

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“…There were no cases of mortality. The studies published about mortality with both techniques are so far similar, except in high-risk patients, in whom a mortality reduction has been demonstrated with MICS [10][11][12][13] ; similarly, lower early and late mortality has been documented in the literature, mainly in aortic valve replacement surgeries, as well as less postoperative bleeding and lower blood products' requirements [14][15][16][17][18][19] . A cohort study adjusted for risk propensity leveling showed that mitral valve repair and replacement techniques through right thoracotomy can be considered short-and long-term safe and efficacious procedures 20 .…”

Section: Discussionmentioning

confidence: 99%

Pediatric heart surgery minimally invasive: experience of a Colombian center

Hernández¹,

Fajardo²,

Díaz³

et al. 2022

ACME

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Objective: During the past decades, cardiac surgery has revolutionized; there is a growing interest in minimizing the physical aggression of surgical procedures, seeking a quick recovery, minimally invasive approaches have been a trend in recent years, with safety and efficacy equivalent to traditional techniques sternotomy. The objective of this study is to compare clinical results between pediatric patients with congenital heart disease undergoing minimally invasive surgery versus standard sternotomy. Methods: Case-control study, nested in a retrospective cohort. All pediatric patients over 10 kg in weight were included, between 2014 and 2019 who underwent surgical correction of simple congenital heart disease, in a cardiovascular center in Medellin. A case was defined as one that underwent a minimally invasive approach (minimally-invasive cardiac surgeries [MICS]) and control patients who were approached in a conventional manner (CONV). 122 patients were admitted, with a mean age (MICS: 6,(4)(5)(6)(7)(8)(9)(10)(11)(12)(2)(3)(4)(5)(6)(7)(8). No differences were found in the baseline characteristics of both groups. No statistically significant difference was documented in infusion times ; p = 0.54), nor differences in complications (MICS: 7.4 vs. CONV: 8.8%; p = 0.77). MICS patients had lactate on admission and a shorter intensive care unit stay than controls. Conclusion: The MICS approach turns out to be a novel, less invasive, safe and efficient technique compared to the conventional surgical approach for the repair of simple congenital heart disease in pediatric patients.

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Section: Discussionmentioning

confidence: 99%

Pediatric heart surgery minimally invasive: experience of a Colombian center

Hernández¹,

Fajardo²,

Díaz³

et al. 2022

ACME

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“…No se presentó ningún caso de mortalidad. Los estudios publicados de mortalidad en ambas técnicas son similares hasta la fecha, excepto en los pacientes de alto riesgo, en quienes se ha demostrado una reducción en la mortalidad con MICS [10][11][12][13] ; igualmente se ha documentado en la literatura menor mortalidad precoz y tardía, principalmente en las cirugías de recambio valvular aórtico, así como un menor sangrado postoperatorio y menor requerimiento de hemoderivados [14][15][16][17][18][19] . En un estudio de cohortes ajustadas por nivelación del riesgo de propensión, demostró que las técnicas de reparo y sustitución de la válvula mitral a través de toracotomía derecha pueden considerarse un procedimiento seguro y eficaz corto y largo plazo 20 .…”

Section: Discussionunclassified

Cirugía cardiaca pediátrica mínimamente invasiva: experiencia de un centro colombiano cardiovascular

Hernández-Ruiz

Fajardo

Díaz

et al. 2021

ACM

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Durante las últimas décadas, la cirugía cardiaca ha evolucionado, existe un interés creciente en minimizar la agresión corporal de procedimientos quirúrgicos, buscando una rápida recuperación, los abordajes mínimamente invasivos han sido tendencia en los últimos años, con seguridad y eficacia equivalente a las técnicas tradicionales de esternotomía. El objetivo de este estudio es comparar resultados clínicos entre pacientes pediátricos con cardiopatías congénitas sometidos a cirugía mínimamente invasiva frente a esternotomía estándar. Métodos: Estudio de casos y controles, anidado en una cohorte retrospectiva. Se incluyeron todos los pacientes pediátricos mayores de 10 kg de peso, sometidos entre 2014 a 2019 a corrección quirúrgica de cardiopatías congénitas simples, en un centro cardiovascular en Medellín. Se definió caso aquel que fuera sometido a abordaje mínimamente invasivo (MICS) y control los pacientes que se abordaron de manera convencional (CONV). Un total de 122 pacientes fueron admitidos, con una media de edad ). No se encontraron diferencias en las características basales de ambos grupos. No se documentó diferencia estadísticamente significativa en los tiempos de perfusión ; p= 0,54), ni diferencias en las complicaciones (MICS: 7.4% vs. CONV: 8.8%; p = 0.77). Los pacientes MICS tuvieron un lactato al ingreso y una estadía en la UCI menor que los controles. Conclusión: El abordaje MICS resulta ser una técnica novedosa, menos invasiva, segura y eficiente, frente al abordaje quirúrgico CONV, para la reparación de cardiopatías congénitas simples en paciente pediátricos.

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“…Conventional surgical repair under CPB via the median sternotomy approach is the standard treatment for ASD [2, 3]. Other surgical incisions, including right anterolateral thoracotomy and right axillary thoracotomy, are used to obtain better cosmetic results [11–14]. However, these surgical treatments are all associated with operative trauma, the potential risk of CPB, visible scar formation, postoperative discomfort and the possible need for blood transfusion.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter and intraoperative device closure and surgical repair for atrial septal defect

Qiu¹,

Chen²,

Hong³

et al. 2019

J Cardiothorac Surg

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Background Transcatheter and intraoperative device closure for atrial septal defect (ASD) are widely applied to reduce the incision size and the potential for injury during cardiopulmonary bypass (CPB) in conventional surgical repair. No studies had been conducted to compare the safety and efficiency of these three treatments. Methods From January 2018 to April 2018, 87 patients with an isolated ASD who had undergone transcatheter device closure ( n = 45), intraoperative device closure ( n = 22) and surgical repair ( n = 20) were retrospectively reviewed and further analyzed to compare these three treatments. Results The successful closure rate was similar in the three groups. There was a significant difference in aortic cross-clamping time, CPB duration and operative time between the surgical group and the device groups. The length of intensive care unit stay, postoperative mechanical ventilation time and length of hospital stay were shorter in the two device groups than in the surgical group. The incision was the most extended in the surgical group. Regarding major adverse events, no significant differences were found among the three groups. Conclusions Transcatheter and intraoperative device closure and surgical repair for ASD are all safe and effective. Considering their respective disadvantages and advantages, the transcatheter approach may be the first choice for an isolated secundum ASD, the intraoperative approach may be the second choice, and surgical repair may be the last resort.

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Cirugía mínimamente invasiva en niños. Corrección de la comunicación interauricular por vía axilar y submamaria

Cited by 22 publications

References 24 publications

Pediatric heart surgery minimally invasive: experience of a Colombian center

Pediatric heart surgery minimally invasive: experience of a Colombian center

Cirugía cardiaca pediátrica mínimamente invasiva: experiencia de un centro colombiano cardiovascular

Transcatheter and intraoperative device closure and surgical repair for atrial septal defect

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