Atrial septal defect minimally invasive repair: Difference between revisions
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{{Atrial septal defect}} | {{Atrial septal defect}} | ||
{{CMG}}; '''Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto: | {{CMG}}; '''Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto:psingh13579@gmail.com]; {{CZ}} '''Assistant Editor(s)-In-Chief:''' [[Kristin Feeney|Kristin Feeney, B.S.]] [mailto:kfeeney@elon.edu] | ||
==Overview== | ==Overview== | ||
Minimally invasive repair of [[atrial septal defect]] has been shown to be as successful as the conventional [[sternotomy]]. Although they have not been associated with reduced morbidity and mortality rates, they have been proven to have the advantage of being less invasive, less post-surgical complications, decreased hospital stay, and more cosmetic benefits. | |||
==Minimally | ==Minimally Invasive Repair== | ||
===Steps in the | ===Minimally Invasive Approach to Atrial Septal Defect/ Mini-Thoracotomy=== | ||
* Incision made through the right side of the chest. | ====Steps in the Surgery==== | ||
* Patient put on | * Incision made through the right side of the [[chest]]. | ||
* Tubes placed in the main artery and vein of the right leg | * Patient put on heart-lung bypass machine. | ||
* Tubes placed in the main [[artery]] and [[vein]] of the right leg. | |||
* The heart stopped during operation. | * The heart stopped during operation. | ||
* Right atrium opened and [[atrial septal defect]] exposed | * Right atrium opened and [[atrial septal defect]] exposed. | ||
* Defect repaired | * Defect repaired. | ||
* Heart closed and restarted | * Heart closed and restarted. | ||
* Heart-lung bypass is discontinued | * Heart-lung bypass is discontinued. | ||
===Advantages=== | |||
====Types of Incision==== | |||
*Upper hemisteronomy | |||
*Right parasternal | |||
*Right submammary bikini line (for females) | |||
*Limited [[median sternotomy]] (for males) | |||
*Transxiphoid sternotomy (for children or young adults) | |||
It is advised that an anterolateral approach only be used in adults as it may damage prepubescent girls during development of [[breast]] tissue. | |||
====Advantages==== | |||
* Less invasive | * Less invasive | ||
* | * Reduced hospital stay | ||
* | * Faster recovery and healing of [[wound]] due to reduced size of incision | ||
* No or minimal activity restrictions post-surgery | * No or minimal activity restrictions post-surgery | ||
* | * Reduced rate of wound [[infection]] | ||
==Trial | ===Trial Supportive Data=== | ||
Studies done on 68 patients (39 | Studies done on 68 patients (39 conventional sternotomy, 29 [[minimally invasive surgery|minimally invasive ASD closure]]) to compare the safety and efficacy of [[minimally invasive surgery|minimally invasive ASD closure]] compared to the conventional sternotomy approach (CSA) found no statistically significant difference in morbidity and mortality. However, a significant difference in postoperative length of stay was seen. Thus, [[minimally invasive surgery|minimally invasive ASD closure]] (MIC) was found to be as effective as conventional sternotomy approach (CSA) with the advantage of decreased hospital stay <ref name="pmid12735575">{{cite journal| author=Ryan WH, Cheirif J, Dewey TM, Prince SL, Mack MJ| title=Safety and efficacy of minimally invasive atrial septal defect closure. | journal=Ann Thorac Surg | year= 2003 | volume= 75 | issue= 5 | pages= 1532-4 | pmid=12735575 | doi= | pmc= | url= }} </ref>. | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
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[[CME Category::Cardiology]] | |||
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[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Congenital heart disease]] | [[Category:Congenital heart disease]] | ||
[[Category:Pediatrics]] | [[Category:Pediatrics]] | ||
[[Category:Embryology]] | [[Category:Embryology]] | ||
[[Category:Disease | [[Category:Disease]] | ||
Latest revision as of 01:58, 15 March 2016
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Surgery | |
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Atrial septal defect minimally invasive repair On the Web | |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Cafer Zorkun, M.D., Ph.D. [3] Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [4]
Overview
Minimally invasive repair of atrial septal defect has been shown to be as successful as the conventional sternotomy. Although they have not been associated with reduced morbidity and mortality rates, they have been proven to have the advantage of being less invasive, less post-surgical complications, decreased hospital stay, and more cosmetic benefits.
Minimally Invasive Repair
Minimally Invasive Approach to Atrial Septal Defect/ Mini-Thoracotomy
Steps in the Surgery
- Incision made through the right side of the chest.
- Patient put on heart-lung bypass machine.
- Tubes placed in the main artery and vein of the right leg.
- The heart stopped during operation.
- Right atrium opened and atrial septal defect exposed.
- Defect repaired.
- Heart closed and restarted.
- Heart-lung bypass is discontinued.
Types of Incision
- Upper hemisteronomy
- Right parasternal
- Right submammary bikini line (for females)
- Limited median sternotomy (for males)
- Transxiphoid sternotomy (for children or young adults)
It is advised that an anterolateral approach only be used in adults as it may damage prepubescent girls during development of breast tissue.
Advantages
- Less invasive
- Reduced hospital stay
- Faster recovery and healing of wound due to reduced size of incision
- No or minimal activity restrictions post-surgery
- Reduced rate of wound infection
Trial Supportive Data
Studies done on 68 patients (39 conventional sternotomy, 29 minimally invasive ASD closure) to compare the safety and efficacy of minimally invasive ASD closure compared to the conventional sternotomy approach (CSA) found no statistically significant difference in morbidity and mortality. However, a significant difference in postoperative length of stay was seen. Thus, minimally invasive ASD closure (MIC) was found to be as effective as conventional sternotomy approach (CSA) with the advantage of decreased hospital stay [1].