Minimally invasive video-assisted surgical closure of atrial septal defects: a safe approach

Anna Sabate Rotes, Harold M. Burkhart, Rakesh M. Suri, Martha Grogan, Nathaniel W. Taggart, Zhuo Li, Hartzell V Schaff, Joseph A. Dearani

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

OBJECTIVE: To compare the safety and effectiveness of video-assisted thoracic surgery (VATS) versus conventional median sternotomy (open) in the repair of secundum atrial septal defect (ASD) or patent foramen ovale (PFO).

DESIGN: Among 415 consecutive patients undergoing open or VATS ASD/PFO closure between 1993 and October 2012, 153 patients were compared using 2:1 frequency matching (n=102 open vs 51 VATS). Matching variables include age, gender, body surface area, past medical history of neurologic events, and need of patch closure. Median age was 43 years (3-71 years), and 67% were female.

RESULTS: There were no early deaths in either group. There were no conversions to open sternotomy. Although mean cross-clamp time (14.5±7.6 vs 26.3±13.2 minutes, P<.001) and bypass time (31.7±13.8 vs 60.9±20.9 minutes, P<.001) were longer in the VATS group, patients who underwent VATS had shorter postoperative ventilation time (7.5±6.4 vs 4.4±2.8 hours, P=.03) with 62.7% extubated in the operating room, along with shorter intensive care unit stay (26.7±10.8 vs 19.1±9.9 hours, P<.001) and hospital stay (5.2±1.9 vs 3.5±0.9 days, P<.001). At early follow-up (mean 1.5 years, maximum 4.2 years), there was no difference in need for reintervention. Of the 27 patients who underwent VATS ASD/PFO closure for a neurologic event, none had a recurrence.

CONCLUSION: The use of VATS provides a safe, equally effective alternative to conventional sternotomy for ASD/PFO closure, using a less invasive approach.

Original languageEnglish (US)
Pages (from-to)527-533
Number of pages7
JournalWorld journal for pediatric & congenital heart surgery
Volume5
Issue number4
DOIs
StatePublished - Oct 1 2014

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Video-Assisted Thoracic Surgery
Atrial Heart Septal Defects
Patent Foramen Ovale
Sternotomy
Nervous System
Body Surface Area
Operating Rooms
Intensive Care Units
Ventilation
Length of Stay
Safety
Recurrence

Keywords

  • atrial septal defect
  • congenital
  • congenital heart disease
  • heart surgery
  • minimally invasive surgery

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Minimally invasive video-assisted surgical closure of atrial septal defects : a safe approach. / Sabate Rotes, Anna; Burkhart, Harold M.; Suri, Rakesh M.; Grogan, Martha; Taggart, Nathaniel W.; Li, Zhuo; Schaff, Hartzell V; Dearani, Joseph A.

In: World journal for pediatric & congenital heart surgery, Vol. 5, No. 4, 01.10.2014, p. 527-533.

Research output: Contribution to journalArticle

Sabate Rotes, Anna ; Burkhart, Harold M. ; Suri, Rakesh M. ; Grogan, Martha ; Taggart, Nathaniel W. ; Li, Zhuo ; Schaff, Hartzell V ; Dearani, Joseph A. / Minimally invasive video-assisted surgical closure of atrial septal defects : a safe approach. In: World journal for pediatric & congenital heart surgery. 2014 ; Vol. 5, No. 4. pp. 527-533.
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T1 - Minimally invasive video-assisted surgical closure of atrial septal defects

T2 - a safe approach

AU - Sabate Rotes, Anna

AU - Burkhart, Harold M.

AU - Suri, Rakesh M.

AU - Grogan, Martha

AU - Taggart, Nathaniel W.

AU - Li, Zhuo

AU - Schaff, Hartzell V

AU - Dearani, Joseph A.

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N2 - OBJECTIVE: To compare the safety and effectiveness of video-assisted thoracic surgery (VATS) versus conventional median sternotomy (open) in the repair of secundum atrial septal defect (ASD) or patent foramen ovale (PFO).DESIGN: Among 415 consecutive patients undergoing open or VATS ASD/PFO closure between 1993 and October 2012, 153 patients were compared using 2:1 frequency matching (n=102 open vs 51 VATS). Matching variables include age, gender, body surface area, past medical history of neurologic events, and need of patch closure. Median age was 43 years (3-71 years), and 67% were female.RESULTS: There were no early deaths in either group. There were no conversions to open sternotomy. Although mean cross-clamp time (14.5±7.6 vs 26.3±13.2 minutes, P<.001) and bypass time (31.7±13.8 vs 60.9±20.9 minutes, P<.001) were longer in the VATS group, patients who underwent VATS had shorter postoperative ventilation time (7.5±6.4 vs 4.4±2.8 hours, P=.03) with 62.7% extubated in the operating room, along with shorter intensive care unit stay (26.7±10.8 vs 19.1±9.9 hours, P<.001) and hospital stay (5.2±1.9 vs 3.5±0.9 days, P<.001). At early follow-up (mean 1.5 years, maximum 4.2 years), there was no difference in need for reintervention. Of the 27 patients who underwent VATS ASD/PFO closure for a neurologic event, none had a recurrence.CONCLUSION: The use of VATS provides a safe, equally effective alternative to conventional sternotomy for ASD/PFO closure, using a less invasive approach.

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