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MINIMALLY INVASIVE TREATMENT FOR ATRIAL SEPTAL DEFECT USING THE RIGHT VERTICAL INFRA-AXILLARY MINI-THORACOTOMY APPROACH AT VIETNAM NATIONAL CHILDREN’S HOSPITAL
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Abstract
Objective: Evaluate the efficacy and primary outcomes of minimally invasive treatment for atrial septal defect using the right vertical infra-axillary mini-thoracotomy approach at Vietnam National Children’s Hospital. Methods: Retrospective study was conducted to evaluate patients diagnosed with atrial septal defect who underwent surgical repair using the right vertical infra-axillary mini-thoracotomy at Heart Center-Vietnam National Children’s Hospital from August 2019 to August 2022. Results: During the study period, a total of 94 patients was retrospectively studied. There were 45 males and 49 females. The median age and median weight of patients in this study were 35.9 months (IQR, 16-73.7 months) and 12 kg (IQR, 8.5-16.3 kg), respectively. Sixteen patients (17%) had partial anomalous pulmonary venous return, 5 (5.3%) had supravalvar pulmonary stenosis, 3 (3.2%) had pulmonary valve stenosis. The mean length of skin incision was 5.4 ± 0.6 cm. The mean time of operation, bypass time, and aortic cross-clamp time were 150.3 ± 35.1 minutes, 29.7 ± 18.5 minutes, and 51.1 ± 25.1 minutes. There were 69 patients (73.4%) who had secondum atrial septal defect, and 25 had sinus venousus atrial septal defect. The defect was closed directly in 45 patients (47.9%), and an autologous pericardial patch has been used in 49 patients (52.1%). No patient needs to convert from another approach. There were 2 patients required reoperation for bleeding control and 1 patient had extracorporeal membrane oxygenation support. The mean time of postoperative ventilation was 8.6 ± 14.9 hours, and the mean time of postoperative hospital stay was 9.0 ± 4.2 days. No early mortality or late mortality in this group at the latest follow-up. All patients and their parents were satisfied with the cosmetic results of this approach. Conclusions: Primary results of surgical repair for atrial septal defect using the right vertical infra-axillary mini-thoracotomy approach were safe and effective. This surgical approach has high a strong cosmetic impact and satisfies the patient’s and family’s expectations.
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Keywords
atrial septal defect, minimally invasive surgery, the right vertical infra-axillary mini-thoracotomy approach
References
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