Totally Endoscopic Cardiac Surgery for Atrial Septal Defect Repair on Beating Heart without Robotic Assistance in 25 Patients

Abstract

The aim of the study was to investigate the effectivity and safety of totally endoscopic cardiac surgery without robotic assistance for atrial septal defect (ASD) closure on beating hearts. Methods: Twenty-five patients (adults/children: 15/10) underwent ASD closure using nonrobotically assisted totally endoscopic approach on beating heart. Three 5-mm trocars and one 12-mm trocar were used, only the superior vena cava is snared, filling the pleural and pericardial cavities with CO 2 , and the heart was beating during the surgery. Twentythree patients had isolated secundum ASD (2 of which had severe tricuspid regurgitation) and two patients had ASD combined with partial anomalous pulmonary venous connection. All ASDs were closed using artificial patch, continuous suture; tricuspid regurgitations were repaired and the anomalous pulmonary veins were drained to the left atrium. Results: No postoperative complications or deaths occurred. Mean ± SD operation time and mean cardiopulmonary bypass time were 267.2 ± 44.6 and 156.1 ± 33.6 min, respectively. These patients were extubated within the first 5 hours, and the volume of blood drainage on the first day was less than 80 mL. Four days after surgery, patients did not need analgesics and were able to return to normal activities 1 week postoperatively. Conclusions: Totally endoscopic operation for ASD closure on beating heart is safe, with short recovery period, and surgical scars are of high cosmetic value, especially in a woman and girl.

Totally Endoscopic Surgery for Repairing Sinus Venosus Atrial Septal Defect Using Double-Patch Technique on Beating Heart

“…In ASD repair, a beating heart with pleural and pericardial cavities filled with CO 2 has many advantages, including (1) safety, (2) time savings and limited bleeding due to no touch on the ascending aorta, and (3) a more extensive surgical field. 15–17 Through this study, we found that the absence of a transthoracic clamp allowed the SVC and related structures to be observed more clearly. In addition, the surgical steps on the SVC, including the SVC snaring, the first patch, and the second patch, could be done quickly with average times of 8.8 ± 3.4 min, 25.0 ± 9.6 min, and 25.9 ± 9.0 min, respectively (Table 4).…”

Totally Endoscopic Surgical Repair of Partial Atrioventricular Septal Defect in Children

“…Because the pressures of the arterial line were significantly raised immediately after starting CPB, an additional arterial cannula was directly placed into left common FA to reduce the pressure. 4 We chose arterial cannula, which is 4F smaller in size compared with a standard size based on patient's weight (10F and 12F vs. 14F and 16F, respectively). With the aim of reducing the arterial pressure, this method not only helped save the time (compared with sewing another graft) but also secured leg perfusion.…”