Atrial septal defect minimally invasive repair: Difference between revisions

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==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 invasive repair of [[atrial septal defect]] has been shown to be as successful as the conventional [[sternotomy]], with the added advantage of being less invasive, less post-surgical complications and decreased hospital stay.


==Minimally Invasive Repair==
==Minimally Invasive Repair==
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====Advantages====
====Advantages====
* Less invasive
* Less invasive
* Smaller hospital stay
* Reduced hospital stay
* Smaller recovery and faster healing of [[wound]]
* 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
* Lesser [[infection]]s
* Reduced rate of wound [[infection]]


===Trial Supportive Data===
===Trial Supportive Data===
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==References==
==References==
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{{reflist|2}}
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[[Category:Best pages]]
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[[Category:Embryology]]
[[Category:Embryology]]
[[Category:Disease]]
[[Category:Disease]]
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Latest revision as of 01:58, 15 March 2016

Atrial Septal Defect Microchapters

Home

Patient Information

Overview

Anatomy

Classification

Ostium Secundum Atrial Septal Defect
Ostium Primum Atrial Septal Defect
Sinus Venosus Atrial Septal Defect
Coronary Sinus
Patent Foramen Ovale
Common or Single Atrium

Pathophysiology

Epidemiology and Demographics

Risk Factors

Natural History and Prognosis

Complications

Diagnosis

History and Symptoms

Physical Examination

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography

Transesophageal Echocardiography
Transthoracic Echocardiography
Contrast Echocardiography
M-Mode
Doppler

Transcranial Doppler Ultrasound

Cardiac Catheterization

Exercise Testing

ACC/AHA Guidelines for Evaluation of Unoperated Patients

Treatment

Medical Therapy

Surgery

Indications for Surgical Repair
Surgical Closure
Minimally Invasive Repair


Robotic ASD Repair
Percutaneous Closure
Post-Surgical Follow Up

Special Scenarios

Pregnancy
Diving and Decompression Sickness
Paradoxical Emboli
Pulmonary Hypertension
Eisenmenger's Syndrome
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Case #1

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].

References

  1. Ryan WH, Cheirif J, Dewey TM, Prince SL, Mack MJ (2003). "Safety and efficacy of minimally invasive atrial septal defect closure". Ann Thorac Surg. 75 (5): 1532–4. PMID 12735575.

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