Minimally Invasive Surgery for Congenital Heart Defects in Paediatric Patients

Abstract

Background: In selected cases, minimally-invasive approaches are favoured for the correction of congenital heart defects with regard to better cosmetic results. Methods: Between July 1999 and April 2001, 25 children (9 male; mean age 5.8 ± 4.1 years; mean weight 19.6 ± 12.6 kg) were operated on using minimally invasive approaches. Diagnoses were: ASD (n = 19), VSD (n = 2), ostium primum defect (n = 3) and Tetralogy of Fallot (n = 1). Female patients with ASD underwent a limited right anterolateral thoracotomy. A ministernotomy was chosen in male patients, in patients under 6 months of age, and in patients with malformations other than ASD. Cannulation was always performed via the chest incision. Results: There were no perioperative complications. Mean operation time was 3.23 ± 0.89 h. Twelve patients were extubated immediately after surgery, mean ventilation time in the others was 12.1 ± 11.7 h. Mean ICU stay and hospital stay were 1.5 ± 0.75 days and 8.3 ± 2.2 days, respectively. Follow-up (mean 4.8 ± 4.6 months) was uneventful. Conclusions: Intracardiac repair of some congenital heart defects can be performed safely and effectively via minimally-invasive approaches. Indications are expanding towards more complex defects. Exposure for precise repair is good, additional incisions can be avoided, and cosmetic results have been excellent.

Congenital heart surgery - Minimally invasive surgery - Ministernotomy - Anterolateral thoracotomy

References

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