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. 2023 Jan 30:7:8.
doi: 10.21037/shc-22-36. Epub 2022 Dec 6.

Simultaneous minimally invasive uniportal atrial septal defect repair and pulmonary lobectomy: a case report

Dmitry V Bazarov  1 , Andrei I Gritsiuta  2 , Evgeny P Evseev  3 , Roman V Petrov  4
Affiliations

Simultaneous minimally invasive uniportal atrial septal defect repair and pulmonary lobectomy: a case report

Dmitry V Bazarov et al. Shanghai Chest. .

Abstract

Background: Combination of non-oncological pulmonary and cardiac conditions is common entity in modern thoracic surgery, allowing concurrent surgical correction. Multiple publications in the literature address the success of simultaneous interventions for combined conditions, however almost all are performed with an open approach.

Case description: A 49-year-old male with past medical history significant for bronchiectasis, complicated by fibrosis of the middle lobe, presented with dyspnea, recurrent hemoptysis, and nonproductive cough. Echocardiography revealed a large atrial septal defect (ASD), biventricular enlargement with severe mitral and tricuspid regurgitation. After multidisciplinary evaluation, patient was taken to the operating room for simultaneous cardiac intervention with right middle lobectomy. The total duration of surgery was 332 min, with cross-clamp time of 79 min. Estimated blood loss was 800 mL. Patient was extubated 3 h postoperatively, chest tube was removed on postoperative day 4 and the patient was discharged home on postoperative day 8 without postoperative complications.

Conclusions: In this article, we describe the first case of simultaneous thoracoscopic uniportal intervention with cardiopulmonary bypass (CPB) in the treatment of multiple congenital heart defects and pulmonary complications of bronchiectasis. Presented case demonstrates potential advantage and feasibility of minimally invasive simultaneous procedures in patients with concurrent pulmonary and cardiac conditions. The described approach allowed radical surgical intervention to address both problems in the single setting, while retaining advantage of minimally invasive intervention.

Keywords: Congenital heart defect; case report; fibroatelectasis; thoracoscopy; uniportal VATS.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://shc.amegroups.com/article/view/10.21037/shc-22-36/coif). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
CT scan with axial (A) and sagittal (B) reconstructions. The arrow indicates fibroatelectasis of the RML. CT, computerized tomography; RML, right middle lobe.
Figure 2
Figure 2
An intraoperative view of a surgical access and femoral canulation of the patient.
Figure 3
Figure 3
An atriotomy view during the cardiac stage of the simultaneous procedure.
See this image and copyright information in PMC

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