ĐÁNH GIÁ KẾT QUẢ SỚM CỦA PHẪU THUẬT TIM ÍT XÂM LẤN ĐÓNG THÔNG LIÊN NHĨ QUA ĐƯỜNG NGỰC PHẢI Ở NGƯỜI LỚN

Abstract

Objective: To evaluate the safety and efficacy of minimally invasive atrial septal defect (ASD) closure through right thoracotomy in adults. Methods: A retrospective descriptive case series. Results: from May 2022 to June 2024, there were 44 patients (17 males, 27 females) who underwent minimally invasive ASD closure through a right thoracotomy at Cho Ray hospital. The mean age was 37,1 ± 10,8 years (range 19 – 65). Of the 44 patients, 38 (86,4%), 3 (6,8%), 2 (4,6%), and 1 (2,3%) had secundum ASD, primum ASD, superior sinus venosus ASD, and inferior sinus venosus ASD, respectively. Abnormal pulmonary venous return was recorded in 2 cases (4,6%). Concomitant cardiac defect repair surgery was performed in 29 cases (65,9%). No in-hospital mortality was recorded. The cardiopulmonary bypass time was 73 ± 28 minutes (range 25 – 130), and the surgery time averaged 163 ± 42 minutes (range 80 – 250). Mechanical ventilation time was 9,2 ± 3,9 hours (range 3,5–17,3), ICU stay was 34,7 ± 24,2 hours (range 15,5 – 116), and postoperative hospital stay was 8 ± 4 days (range 4–21). No residual shunts were recorded after surgery. Major complications: Two patients (4,6%) required permanent pacemaker implantation. Minor complications: Six patients (13,7%) had pneumothorax, and 8 patients (18,2%) developed pneumonia requiring antibiotic treatment. No patients required reoperation for bleeding control or had wound infections. Conclusion: Minimally invasive ASD closure through right thoracotomy in adults had proven to be highly safe and effective.