Korean J Thorac Cardiovasc Surg.  2016 Dec;49(6):421-426. 10.5090/kjtcs.2016.49.6.421.

Minimally Invasive Cardiac Surgery versus Conventional Median Sternotomy for Atrial Septal Defect Closure

Affiliations
  • 1Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Korea. kkh726@snu.ac.kr

Abstract

BACKGROUND
Median sternotomy is the standard approach for atrial septal defect (ASD) closure. However, minimally invasive cardiac surgery (MICS) has been introduced at many centers in adult/grown-up congenital heart patients. We retrospectively reviewed the results of right anterolateral thoracotomy compared with conventional median sternotomy (CMS) for ASD closure at Seoul National University Hospital.
METHODS
We retrospectively analyzed 60 adult patients who underwent isolated ASD closure from January 2004 to December 2013 (42 in the CMS group, 18 in the MICS group). Preoperative, operative, and postoperative data were collected and compared between the 2 groups.
RESULTS
The MICS group was younger (44.6 years vs. 32.4 years, p=0.002) and included more females (66.7% vs. 94.4%, p=0.025) than the CMS group. Operation time (188.4 minutes vs. 286.7 minutes, p<0.001), cardiopulmonary bypass time (72.7 minutes vs. 125.8 minutes, p<0.001), and aortic cross-clamp time (25.5 minutes vs. 45.6 minutes, p<0.001) were significantly longer in the MICS group. However, there were no significant differences in morbidity and mortality between groups. Only chest tube drainage in the first 24 hours (627.1 mL vs. 306.1 mL, p<0.001) exhibited a significant difference.
CONCLUSION
MICS via right anterolateral thoracotomy is an alternative choice for ASD closure. The results demonstrated similar morbidity and mortality between groups, and favored MICS in chest tube drainage in the first 24 hours.

Keyword

Sternotomy; Minimally invasive surgery; Congenital heart disease; Atrial heart septal defects

MeSH Terms

Adult
Cardiopulmonary Bypass
Chest Tubes
Drainage
Female
Heart
Heart Defects, Congenital
Heart Septal Defects, Atrial*
Humans
Minimally Invasive Surgical Procedures
Mortality
Retrospective Studies
Seoul
Sternotomy*
Thoracic Surgery*
Thoracotomy
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