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. 2016 Jan 27:2:21.
doi: 10.3978/j.issn.2221-2965.2015.12.05. eCollection 2016.

Minimally invasive repair of fenestrated atrial septal aneurysm

Seph Naficy  1 , James E Klemis  2 , Steven S Gubin  2 , William R Funderburg  3 , John M Craig  4   5
Affiliations

Minimally invasive repair of fenestrated atrial septal aneurysm

Seph Naficy et al. J Vis Surg. .

Abstract

Background: Atrial septal aneurysms (ASAs) are uncommon but are associated with significant embolic morbidity when an interatrial communication is present. Although surgical reconstruction has traditionally been approached through a median sternotomy, minimally invasive techniques may be employed to reduce pain and recovery time.

Methods: We present a video-assisted technique via right inframammary minithoracotomy utilizing peripheral cannulation for cardiopulmonary bypass. Included is a discussion of surgical tips, potential pitfalls and a description of unique technical aspects that differentiate atrial septal repair from other minimally invasive cardiac operations.

Results: A complete repair of the defect was confirmed by intraoperative transesophageal echocardiography (TEE). The patient made an uncomplicated recovery and was discharged home within 48 hours of surgery.

Conclusions: Minimally invasive repair of an ASA utilizing peripheral cannulation for cardiopulmonary bypass and a right inframammary incision can be accomplished with satisfactory technical success and recovery time.

Keywords: Atrial septal aneurysm (ASA); atrial septal defect; minimally invasive cardiac surgery; peripheral cannulation; transesophageal echocardiography (TEE).

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Pre-repair TEE (15). TEE, transesophageal echocardiography. Available online: http://www.asvide.com/articles/781
Figure 2
Figure 2
Positioning, instrumentation and cannulation (17). Available online: http://www.asvide.com/articles/782
Figure 3
Figure 3
Pericardiotomy (18). Available online: http://www.asvide.com/articles/783
Figure 4
Figure 4
Caval dissection and control (19). Available online: http://www.asvide.com/articles/784
Figure 5
Figure 5
Placement of cardioplegia catheter (20). Available online: http://www.asvide.com/articles/785
Figure 6
Figure 6
Clamp placement and cardioplegic arrest (21). Available online: http://www.asvide.com/articles/786
Figure 7
Figure 7
Atriotomy and septal inspection (22). Available online: http://www.asvide.com/articles/787
Figure 8
Figure 8
Resection of atrial septal aneurysm (23). Available online: http://www.asvide.com/articles/788
Figure 9
Figure 9
Patch preparation and septal reconstruction (24). Available online: http://www.asvide.com/articles/789
Figure 10
Figure 10
Post-repair TEE (25). TEE, transesophageal echocardiography. Available online: http://www.asvide.com/articles/790
Figure 11
Figure 11
Appearance of wounds 3 weeks after surgery.
See this image and copyright information in PMC

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