TY - JOUR
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.
PY - 2014/10
Y1 - 2014/10
N2 - 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). 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. 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. The use of VATS provides a safe, equally effective alternative to conventional sternotomy for ASD/PFO closure, using a less invasive approach.
AB - 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). 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. 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. The use of VATS provides a safe, equally effective alternative to conventional sternotomy for ASD/PFO closure, using a less invasive approach.
KW - atrial septal defect
KW - congenital
KW - congenital heart disease
KW - heart surgery
KW - minimally invasive surgery
UR - http://www.scopus.com/inward/record.url?scp=84925883212&partnerID=8YFLogxK
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U2 - 10.1177/2150135114542166
DO - 10.1177/2150135114542166
M3 - Article
C2 - 25324249
AN - SCOPUS:84925883212
SN - 2150-1351
VL - 5
SP - 527
EP - 533
JO - World Journal for Pediatric and Congenital Heart Surgery
JF - World Journal for Pediatric and Congenital Heart Surgery
IS - 4
ER -