Aortopulmonary Window with Subaortic Fibrous Stenosis and Septal Defect: Surgery through a Minimal Right Vertical Infra-Axillary Thoracotomy

2011 ◽  
Vol 14 (4) ◽  
pp. 264 ◽  
Author(s):  
Jun Pan ◽  
Qing-Guo Li ◽  
Qing Zhou ◽  
Jie Zhang ◽  
Qiang Wang ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Cardiopulmonary Bypass ◽  
Ventricular Septal Defect ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Septal Defect ◽  
Subaortic Stenosis ◽  
Aortopulmonary Window ◽  
Cardiac Malformation ◽  
Congenital Cardiac Malformation

Aortopulmonary window with subaortic stenosis and ventricular septal defect is an uncommon congenital cardiac malformation that is repaired using cardiopulmonary bypass. The authors describe a 3-year-old patient on whom we performed surgery through a minimal right vertical infra-axillary thoracotomy. This minimally invasive surgery is likely to be applicable in a few cases.

scholarly journals Clinical and Operative Determinants of Acute Kidney Injury after Cardiac Surgery

2020 ◽  
Vol 10 (5) ◽  
pp. 340-352
Author(s):  
Faeq Husain-Syed ◽  
Maria Giovanna Quattrone ◽  
Fiorenza Ferrari ◽  
Pércia Bezerra ◽  
Salvador Lopez-Giacoman ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Logistic Regression ◽  
Cardiac Surgery ◽  
Minimally Invasive Surgery ◽  
Cardiopulmonary Bypass ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Fluid Balance ◽  
Kidney Injury ◽  
Baseline Serum

Introduction: Cardiac surgery-associated acute kidney injury (CSA-AKI) is associated with increased morbidity and mortality. Objectives: We aimed to identify potentially modifiable risk factors for CSA-AKI. Methods: This was asingle-center retrospective cohort study of 495 adult patients undergoing cardiac surgery. AKI was diagnosed and staged using full KDIGO criteria incorporating baseline serum creatinine (SC) levels and correction of postoperative SC levels for fluid balance. We examined the association of routinely available clinical and laboratory data with AKI using multivariate logistic regression modeling. Results: A total of 103 (20.8%) patients developed AKI: 16 (15.5%) patients were diagnosed with AKI upon hospital admission, and 87 (84.5%) patients were diagnosed with CSA-AKI. Correction of SC levels for fluid balance increased the number of AKI cases to 104 (21.0%), with 6 patients categorized to different AKI stages. Univariate logistic regression analysis identified five preoperative (age, sex, diabetes mellitus, preoperative systolic pulmonary arterial pressure [PSPAP], acute decompensated heart failure) and five intraoperative predictors of AKI (age, sex, red blood cell [RBC] volume transfused, use of minimally invasive surgery, duration of cardiopulmonary bypass). When all preoperative and intraoperative variables were incorporated into one model, six predictors remained significant (age, sex, use of minimally invasive surgery, RBC volume transfused, PSPAP, duration of cardiopulmonary bypass). Model discrimination performance showed an area under the curve of 0.69 for the model including only preoperative variables, 0.76 for the model including only intraoperative variables, and 0.77 for the model including all preoperative and intraoperative variables. Conclusions: Use of minimally invasive surgery and therapies mitigating PSPAP and intraoperative blood loss may offer protection against CSA-AKI.

scholarly journals Percutaneous cannulation for cardiopulmonary bypass in minimally invasive surgery is associated with reduced groin complications

2017 ◽  
Vol 25 (3) ◽  
pp. 377-383 ◽  
Author(s):  
Alexandros Moschovas ◽  
Paulo A. Amorim ◽  
Mariana Nold ◽  
Gloria Faerber ◽  
Mahmoud Diab ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Cardiopulmonary Bypass ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Percutaneous Cannulation

scholarly journals Robotic assisted minimally invasive surgery for atrial septal defect correction

2012 ◽  
Vol 27 (3) ◽  
pp. 488-490 ◽  
Author(s):  
Robinson Poffo ◽  
Alex Luiz Celullare ◽  
Renato Bastos Pope ◽  
Alisson Parrilha Toschi
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Atrial Septal Defect ◽  
Invasive Surgery ◽  
Septal Defect ◽  
Defect Correction ◽  
Robotic Assisted

scholarly journals Closure of atrial septal defect by minimally invasive surgery: An alternative approach

2021 ◽  
Vol 13 (1) ◽  
pp. 140-141
Author(s):  
M. Lenoir ◽  
S. Degirmenci ◽  
J. Rauzier ◽  
P. Aldebert ◽  
A. Casalta ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Atrial Septal Defect ◽  
Invasive Surgery ◽  
Septal Defect ◽  
Alternative Approach

scholarly journals Individualized Strategy of Minimally Invasive Cardiac Surgery in Congenital Cardiac Septal Defects

2021 ◽  
Author(s):  
Jiaquan Zhu ◽  
Yunjiao Zhang ◽  
Chunrong Bao ◽  
Fangbao Ding ◽  
Ju Mei
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Septal Defect ◽  
Right Ventricular Outflow Tract ◽  
Anterolateral Thoracotomy ◽  
Septal Defects ◽  
Vertical Incision ◽  
Residual Lesions ◽  
Mini Thoracotomy

Abstract Background: Intracardiac septal defect tends to be repaired by minimally invasive surgery in both children and adults. This study summarized our strategy of minimally invasive therapy using various lateral mini-thoracotomies in patients with congenital septal defect. Methods: Four hundred and seventy-two patients who underwent minimally invasive repair of intracardiac septal defects (Atrial septal defect, ASD; ventricular septal defect, VSD; atrioventricular septal defect, AVSD) between January 2012 and June 2020 were retrospectively reviewed. Those who underwent device closure were excluded. The minimally invasive strategy included three groups. First, right sub-axillary vertical incision group (RSAVI group, N=335, 192 ASDs, 135 VSDs and 8 AVSDs; Second, right anterolateral thoracotomy group (RALT group, N=132, 77 ASDs, 51 VSDs and 4 AVSDs; Third, left anterolateral thoracotomy group (LALT group, N=5, all of them were sub-pulmonary VSDs).Results: Concomitant surgeries included 9 cases of right ventricular outflow tract obstruction relief, 9 mitral repairs and 37 tricuspid repairs. There was one transition from thoracotomy to sternotomy. Three patients required second pump run for residual lesions (2 residual shunts and 1 mitral regurgitation). The age and body weight of RSAVI group were significantly lower than those of RALT and LALT groups. The mean cardiopulmonary bypass time was 67.3±11.3 min and cross clamp time was 38.1±8.9 min. There was no post-operative death, and complications included 1 chest exploration for bleeding, 1 redo operation due to patch dehiscence during the same admission, 1 transient neural dysfunction, 3 diaphragmatic paresis and 13 atelectasis. The median stay in ICU was 2 days, while the median post-operative hospitalization was 6 days. The echocardiography results before discharge indicated no significant residual lesions. There was no reoperation, no new onset of chest deformities and no sclerosis during the follow up. Conclusions: The commonly seen intracardiac septal defects can be safely and effectively repaired by minimally invasive surgery with good cosmetic results. Right sub-axillary vertical incision is suitable in infants and young children, while right anterior mini-thoracotomy is more commonly used in adolescents and adults. Left anterior mini-thoracotomy is an alternative incision to repair sub-pulmonary artery VSD.

scholarly journals Individualized strategy of minimally invasive cardiac surgery in congenital cardiac septal defects

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Jiaquan Zhu ◽  
Yunjiao Zhang ◽  
Chunrong Bao ◽  
Fangbao Ding ◽  
Ju Mei
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Septal Defect ◽  
Median Sternotomy ◽  
Right Ventricular Outflow Tract ◽  
Anterolateral Thoracotomy ◽  
Septal Defects ◽  
The Right ◽  
Residual Lesions

Abstract Background Intracardiac septal defect is repaired using median sternotomy in most centers; however, there are several reports using minimally invasive surgery in both children and adults. This study summarized our strategy of minimally invasive therapy using various lateral mini-thoracotomies in patients with congenital septal defect. Methods In this study, 472 patients who underwent minimally invasive repair of intracardiac septal defects (atrial septal defect, (ASD), ventricular septal defect, (VSD), and atrioventricular septal defect, (AVSD)) from January 2012 to June 2020 were retrospectively reviewed. Those who underwent device closure were excluded. The minimally invasive strategy included three groups: the right sub-axillary vertical incision (RSAVI) group (N = 335, including192 ASDs, 135 VSDs and 8 AVSDs); the right anterolateral thoracotomy (RALT) group (N = 132, including 77 ASDs, 51 VSDs and 4 AVSDs); and the left anterolateral thoracotomy (LALT) group (N = 5, all subpulmonary VSDs). Results Concomitant surgeries included nine cases of right ventricular outflow tract obstruction relief, nine cases of mitral repairs and 37 cases of tricuspid repairs. There was one transition from thoracotomy to sternotomy. Three patients required second pump run for residual lesions (two residual VSD shunts and one mitral regurgitation). The age and body weight of the RSAVI group were significantly lower than those of the RALT and LALT groups (all P < 0.01). No postoperative death was observed. Postoperative complications included one case of chest exploration for bleeding, one case of reoperation due to patch dehiscence during the same admission, one case of transient neural dysfunction, three cases of diaphragmatic paresis and 13 cases of atelectasis. The median stay in the intensive care unit was two days, while the median postoperative hospitalization duration was six days. The echocardiography results before discharge indicated no significant residual lesions. No reoperation, no new onset of chest deformities and no sclerosis were observed during the follow-up. Conclusions Intracardiac septal defects can be safely and effectively repaired by minimally invasive surgery with good cosmetic results. RSAVI is suitable in infants and children, while RALT is more commonly used in adolescents and adults. LALT is an alternative incision to repair subpulmonary VSD.

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