Minimally invasive pediatric surgery in uncomplicated congenital heart disease

Abstract

Background: We aimed to highlight the use of a minimally invasive approach in uncomplicated congenital heart surgery.

Patients and methods: We investigated retrospectively 32 children below 10 years of age who underwent elective closure of ostium secundum type (n = 27), sinus venosus type (n = 4) and ostium primum type (n = 1) atrial septal defects through a limited skin incision and partial lower sternotomy between August 2001 and December 2008. All patients had cannulation through the same incision for cardiopulmonary bypass.

Results: A pericardial patch was used to close the defect in 8 patients and direct suturing in 24. The mean time from the skin incision to cannulation was 56 ± 23 min. Total bypass time was 27 ± 12 min, and crossclamp time was 15 ± 8 min. Mean length of hospital stay was 4 ± 2 days. We did not encounter any complications or mortality.

Conclusions: A minimally invasive approach, consisting of a limited skin incision and partial lower sternotomy, is a safe, reliable, and cosmetically advantageous method in uncomplicated congenital heart disease surgery, which can be performed widely, and may replace the standard approach without increasing mortality and morbidity.

Keywords: Cardiac surgical procedures; atrial; congenital; heart defects; heart septal defects; minimally invasive; sternotomy; surgical procedures.