Totally endoscopic robotic ventricular septal defect repair in the adult

Gao, Changqing; Yang, Ming; Wang, Gang; Xiao, Chen; Wang, Jiali; Zhao, Yue

doi:10.1016/j.jtcvs.2012.01.027

Cited by 27 publications

(29 citation statements)

References 11 publications

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“…Minimally invasive cardiac surgical techniques usually include the right anterior lateral minimal incision, right axillary minimal incision, and lower sternal minimal incision [6, 19, 20]. In addition, VSDs can also be repaired by robot via a minimally invasive access [21]. However, minimally invasive repair of subarterial VSDs via left anterior mini-thoracotomy is rarely reported.…”

Section: Discussionmentioning

confidence: 99%

Minimally access via left anterior mini-thoracotomy for repair of adult subarterial ventricular septal defects

Liao

Long

Zhu

et al. 2017

J Cardiothorac Surg

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BackgroundMinimally invasive cardiac surgical techniques are increasingly applied in the treatment and management of a variety of adult ventricular septal defects (VSDs). However, repair of adult subarterial VSDs via left anterior mini-thoracotomy is rarely reported. The present study aimed to determine the feasibility and safety of the left anterior mini-thoracotomy for the repair of adult subarterial VSDs.MethodsTwenty-seven adult patients underwent repair of subarterial VSDs via left anterior mini-thoracotomy. The approach includes two options for skin incision access, longitudinal and transverse skin incisions. The skin incision length was 4.1–6.1 cm (mean, 5.1 ± 0.6 cm). The closure of the VSDs was obtained through the main pulmonary artery under direct visualization.ResultsSuccessful repair of the defects was achieved in all the patients. No patients died or converted to median sternotomy. Average durations of cardiopulmonary bypass (CPB) and aortic cross-clamp were 102.5 ± 13.6 min (range, 85–127 min) and 54.6 ± 6.9 min (range, 45–66 min), respectively. No patients required blood transfusion. The average postoperative hospital stay was 5.1 ± 0.7 days (range, 4–6 days). There were no postoperative complications related to the operative procedures or peripheral cannulation. During the follow-up of 5.4–32.3 months, no patients were found to have residual shunt, wound infections, pericardial effusion, neurologic or other complications.ConclusionOur experiences demonstrate that minimally invasive cardiac surgical technique via left anterior mini-thoracotomy can be served as a novel, feasible and safe alternative for the repair of adult subarterial VSDs.

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Section: Discussionmentioning

confidence: 99%

Minimally access via left anterior mini-thoracotomy for repair of adult subarterial ventricular septal defects

Liao

Long

Zhu

et al. 2017

J Cardiothorac Surg

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“…With the incorporation of video-assisted techniques, it has been shown to be safe and effective in different surgical situations (15)(16)(17)(18)(19). However, the acquisition of new abilities such as manipulation The most commonly performed procedure in this series was robotic mitral valve surgery.…”

Section: Discussionmentioning

confidence: 99%

Robotic cardiac surgery in Brazil

Poffo

Toschi

Pope

et al. 2017

Ann. Cardiothorac. Surg.

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Background: Brazil, the largest country and economy in South America, is a major driving force behind the development of new medical technologies in the region. Robotic cardiac surgery (RCS) has been evolving rapidly since 2010, when the first surgery using the DaVinci ® robotic system was performed in LatinAmerica. The aim of this article is to evaluate short and mid-term results in patients undergoing robotic cardiac surgery in Brazil.Methods: From March 2010 to December 2015, 39 consecutive patients underwent robotic cardiac surgery. Twenty-seven patients were male (69.2%), with the mean age of 51.3±17.9 years. Participants had a mean ejection fraction of 62±5%. The procedures included in this study were mitral valve surgery, surgical treatment of atrial fibrillation, atrial septal defect closure, resection of intra-cardiac tumors, totally endoscopic coronary artery bypass and pericardiectomy.Results: The mean time spent on cardiopulmonary bypass (CPB) during RCS was 154.9±94.2 minutes and the mean aortic cross-clamp time was 114.48±75.66 minutes. Thirty-two patients (82%) were extubated in the operating room immediately after surgery. The median intensive care unit (ICU) length of stay was 1 day (ranging from 0 to 25) and the median hospital length of stay was 5 days (ranging from 3 to 25). For each type of procedure, endpoints were individually reported. There were no conversions to sternotomy and no intra-operative complications. Patient follow-up was complete in 100% of the participants, with two early deaths unrelated to the procedures and no re-operations at mid-term.Conclusions: Despite the heterogeneity of this series, RCS appears to be feasible, safe and effective when used for the correction of various intra-and extra-cardiac pathologies. Adopting the robotic system has been a challenge in Brazil, where its limited clinical application may be related to the lack of specific training and the high cost of technology.

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“…Since right atriotomy through the right chest had provided us with excellent and reliable exposure of the right heart and the left atrium for robotic repair of ASD [3], VSD [2,5], mitral valve [6], atrial mass [7,8], and PS (data not published), the initial attempt of novel robotic repair of AVSD via right atriotomy was made with success. The long operation time was thought to be a shortcoming of robotic surgery.…”

Section: Discussionmentioning

confidence: 99%

“…During surgery, general anaesthesia was induced and CPB was set up through peripheral vessels according to our protocol [2,3]. After systemic heparinization, femoral arterial (17 F to 22 F) and venous (21 F or 23 F) cannulation (Metronic, Minneapolis, Minn) was performed through a 2-cm transverse incision at the right groin under the guidance of TEE.…”

Section: Case Presentationmentioning

confidence: 99%

Totally robotic repair of atrioventricular septal defect in the adult

Gao

Yang

Xiao

et al. 2015

J Cardiothorac Surg

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Background: Atrioventricular septal defect (AVSD) accounts for up to 3 % of congenital cardiac defects, which is routinely repaired via median sternotomy. Minimally invasive approach such as endoscopic or robotic assisted repair for AVSD has not been reported in the literature. With the experience with robotic mitral valve surgery and congenital defect repair, we initiated robotic AVSD repair in adults. Case Presentation: In this report, we presented three cases of successful repair of partial and intermediate AVSD by using da Vinci SI surgical system (Intuitive Surgical, Inc., Sunnyvale, CA). Conclusions: Totally robotic AVSD repair via right atriotomy could be safely performed in adults and it may provide superior cosmesis with the comparable surgical outcome of the repair via sternotomy.

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Totally endoscopic robotic ventricular septal defect repair in the adult

Abstract: Total endoscopic robotic ventricular septal defect repair in adult patients is feasible, safe, and efficacious.

Cited by 27 publications

References 11 publications

Minimally access via left anterior mini-thoracotomy for repair of adult subarterial ventricular septal defects

Minimally access via left anterior mini-thoracotomy for repair of adult subarterial ventricular septal defects

Robotic cardiac surgery in Brazil

Totally robotic repair of atrioventricular septal defect in the adult

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