Vascular complications of sheathless intra aortic balloon pump—Retrospective analysis of 200 patients

Abstract

Background: Lower hemisternotomy is a popular minimally invasive approach to correct cardiac lesions. Since June 2000, we started the programme of minimally invasive approach for a variety of cardiac lesions. For the same we have indigenously designed a set of instruments.Methods: Total of 86 patients were operated through this approach. The cardiac lesions corrected include atrial septal defect (ASD) in 60 patients (70%), ventricular septal defect (VSD) in 12 (14%) and mitral valve replacement (MVR) in 14 (16%). The results of ASD closure in 40 patients done through this approach were compared with the control group of patients who underwent ASD closure through full-length sternotomy.Results: In patients in whom ASD closure was done, the mean CPB and aortic cross clamp time in lower hemisternotomy group were significantly longer, 35±14.2 min and 23.3±10.8 min respectively compared to 23±3.9 min and 14±3.5 min in full sternotomy group (p<0.001). Mean ventilation time, blood loss, ICU and hospital stay were significantly low (p<0.001) In patients who were operated through this approach compared with those who were operated through full-length sternotomy.Conslusion: Lower Hemisternotomy is a safe approach in both the pediatric and adult patients and the indigenously designed instrumentation is simple and reusable which helps in improving the operative exposure and ease of surgery.