CARDIOVASCULAR
ENGINEERING
Journal for Extracorporeal Circulation, Assist Devices,Transplantation and Artificial Organs
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CARDIOVASCULAR
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Volume 3, 1998, No 1 |
Abstract:
Background: Minimally invasive intra-cardiac surgery remains a
burgeoning discipline still lacking both adequate instrumentation
and innovative cardiopulmonary bypass circuits. Contemporary
surgical practice remains challenged by both, (i) advances in
catheter technology developed to treat congenital heart disease
exclusive of cardiopulmonary bypass and (ii) continued public
tenacity for "incisionless" surgery. Industrial
vivacity for the rapid development of devices must be held in
check by the surgeon, who must remain the patient’s guardian
with all aspects of this discipline’s developmental process.
Methods: A retrospective analysis of 50 children who underwent
surgical repair of atrial septal defects via a partial sternal
split and limited skin incision (5-7 centimeters) between July,
1995 and September, 1997. Eighteen children were excluded from
this manuscript due to receiving a somewhat larger but still
incomplete sternotomy. Results: The average child’s age and
weight (n = 32) was 6 years and 3 months (range 19 months - 15
years) and 23.9kg (range 11.3 –61.7) respectively. The
average bypass time was 39 minutes (range 19 - 81). Twenty-two
children had a single dose of blood cardioplegia administered,
while 10 children had electrically induced ventricular
fibrillation. Twenty-nine patients had ostium secundum defects
with only 3 having a sinus venosus defect. The average length of
stay was 3.4 days (range 2 - 6). There was no mortality or
significant morbidity. Conclusions: The "mini"
sternotomy continues to evolve as an effective cosmetic
alternative to either submammary or thoracotomy approaches.
Improved cosmetics amongst all age groups with the concomitant
security and familiarity of mediastinal access makes this
surgical approach highly desirable.
Keywords:
minimally invasive, atrial septal defect, pediatric, cardioscopy,
intra-cardiac lesions
Address for Correspondence:
Reference:
(CVE. 1998; 3 (1): 6-8)
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