Minimally invasive cardiac surgery with the partial mini-sternotomy in children.
- Author:
Jeong Ryul LEE
1
;
Hong Gook LIM
;
Sook Whan SUNG
;
Yong Jin KIM
;
Joon Rhyang RHO
;
Kyung Phill SUH
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Korea.
- Publication Type:Original Article
- Keywords:
Minimally invasive surgery
- MeSH:
Analgesics;
Aorta;
Blood Transfusion;
Body Weight;
Cardiopulmonary Bypass;
Catheterization;
Child*;
Deception;
Foreign Bodies;
Heart Defects, Congenital;
Heart Septal Defects, Atrial;
Heart Septal Defects, Ventricular;
Humans;
Intensive Care Units;
Length of Stay;
Male;
Morphine;
Seoul;
Skin;
Sternotomy;
Surgical Procedures, Minimally Invasive;
Tetralogy of Fallot;
Thoracic Surgery*;
Wounds and Injuries
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
1998;31(5):466-471
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Purpose: The safety and efficacy of minimally invasive techniques in congenital heart surgery were tested in this study. Materal and method: Between July 1997 and November 1997, a total of 46 children were underwent minimally invasive cardiac operations at Seoul National University Children's Hospital. Age and body weight of the patients averaged 34.6+/-41.8 (Range: 1~148) months and 14.5+/-9.9 (Range: 3.0~40.0) kg, respectively. Twenty eight patients were male. Preoperative surgical indications included 15 atrial septal defects, 25 ventricular septal defects, 1 foreign body in aorta, 3 partial atrioventricular septal defects, 1 total anomalous pulmonary venous connection (cardiac type), and 1 tetralogy of Fallot. After creating a small lower midline skin incision starting as down as possible from the sternal notch, a vertical midline sternotomy extended from xyphoid process to the level of the second intercostal space, where one of the T-, J-, I-or inverted C-shaped lower lying mini-sternotomy was completed with a creation of unilateral right or bilateral trap door sternal opening. A conventional direct aortic and bicaval cannulation was routine. RESULT: A mean length of skin incision was 6.1+/-1.0 (range: 4.0~9.0) cm. A mean distance between the suprasternal notch and the upper most point of the skin incision was 4.0+/-1.1 (range: 2.0~7.0) cm. Mean cardiopulmonary bypass time, aortic cross-clamp time, and the operation time were 62.9+/-20.0 (range: 28~147), 29.8+/-12.8 (range: 11~79), and 161.1+/-34.5 (range: 100-250) minutes. A mean total amount of postoperative blood transfusion was 71.0+/-68.1 (range: 0~267) cc. All patients were extubated mean 11.3+/-13.8 (range: 1~73) hours after operation. A mean total amount of analgesics used was 0.8+/-1.8 (range: 0~9) mg of morphine. The mean duration of stay in intensive care unit and hospital stay were 35.0+/-32.2 (range: 10~194) hours and 6.2+/-2.0 (range: 3~11) days. There were no wound complications and hospital deaths. CONCLUSION: This short-term experience disclosed that the minimally invasive technique can be feasibly applied in a selected group of congenital heart disease as well as is cosmetically more attractive approach.
