scholarly journals Anterolateral minithoracotomy versus median sternotomy for the surgical treatment of atrial septal defects: a meta-analysis and systematic review

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yu-Qing Lei ◽  
Jian-Feng Liu ◽  
Wen-Peng Xie ◽  
Zhi-Nuan Hong ◽  
Qiang Chen ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Random Effect ◽  
Median Sternotomy ◽  
Operation Time ◽  
Severe Complication ◽  
Cochrane Library ◽  
Complication Rates ◽  
Direct Closure ◽  
Septal Defects ◽  
Atrial Septal Defects

Abstract Background To compare the short-term safety and efficacy of right anterolateral minithoracotomy (ALMT) and median sternotomy (MS) for the surgical treatment of atrial septal defects (ASDs). Methods The PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched for comparative studies focusing on surgical repair of ASDs via ALMT or MS published up to the end of April 27, 2020. We used random-effect or fixed-effect models to obtain pooled estimates. Results A total of 7 publications, including 665 patients (ALMT 296 and MS 369), were included. Age (WMD: 1.80 years, 95% CI 0.31–3.29), weight (WMD: − 0.91 kg, 95% CI − 5.57 to 3.75), sex distribution (OR: 1.00, 95% CI 0.74–1.35) and surgical type (patch or direct closure) (OR: 1.00, 95% CI 0.67–1.49) were comparable in the ALMT group and MS group. No significant differences in the success rate (OR 0.23; 95% CI 0.05–1.07) or severe complication rate (OR 1.46; 95% CI 0.41–5.22) were found between the ALMT group and the MS group. In addition, the differences in the cardiopulmonary bypass (CPB) time (WMD 6.33; 95% CI − 1.92 to 14.58 min, p = 0.13) and the operation time (WMD 5.23; 95% CI − 12.49 to 22.96 min, p = 0.56) between the ALMT group and the MS group were not statistically significant. However, the ALMT group had a significantly longer aortic cross-clamp time (2.37 min more, 95% CI 1.07–3.67 min, p = 0.0003). The intubation time was 1.82 h shorter (95% CI − 3.10 to − 0.55 h; p = 0.005), the intensive care unit (ICU) stay was 0.24 days shorter (95% CI − 0.44 to − 0.04 days; p = 0.02), and the postoperative hospital stay was 2.45 days shorter (95% CI − 3.01 to − 1.88 days; p < 0.00001) in the ALMT group than in the MS group. Furthermore, the incision length was significantly shortened by 8.97 cm in the ALMT group compared with the MS group (95% CI − 9.36 to − 8.58 cm; p < 0.00001). Conclusions In the surgical treatment of ASD, ALMT and MS are equally safe and effective in terms of success rates and severe complication rates. The surgical procedures are equally difficult, but ALMT is associated with a faster functional recovery and better cosmetic results. Compared to MS, ALMT is the better choice for select ASD patients.

scholarly journals Transcatheter Correction of Superior Sinus Venosus Atrial Septal Defects as an Alternative to Surgical Treatment

2020 ◽  
Vol 75 (11) ◽  
pp. 1266-1278 ◽  
Author(s):  
Jan Hinnerk Hansen ◽  
Phuoc Duong ◽  
Salim G.M. Jivanji ◽  
Matthew Jones ◽  
Saleha Kabir ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Sinus Venosus ◽  
Septal Defects ◽  
Atrial Septal Defects

Transxiphoid Approach Without Median Sternotomy for the Repair of Atrial Septal Defects

1998 ◽  
Vol 65 (3) ◽  
pp. 771-774 ◽  
Author(s):  
Miguel Barbero-Marcial ◽  
Carla Tanamati ◽  
Marcelo B Jatene ◽  
Edmar Atik ◽  
Adib D Jatene
Keyword(s):  
Median Sternotomy ◽  
Septal Defects ◽  
Atrial Septal Defects

scholarly journals Experience of Minimal Invasive Cardiac Surgery for repair of Atrial Septal Defects- A Single Center Study

2021 ◽  
Vol 14 (1) ◽  
pp. 37-43
Author(s):  
Mohammad Rokonujjaman ◽  
Naveen SK ◽  
Shaheedul Islam ◽  
Nusrat Ghafoor ◽  
Syed Tanvir Ahmad ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Hospital Stay ◽  
Median Sternotomy ◽  
Minimal Invasive ◽  
Aortic Occlusion ◽  
Invasive Technique ◽  
Safe Procedure ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Icu Stay

Background: Atrial Septal Defects (ASD) can be closed surgically using conventional midline sternotomy or minimal invasive technique. This study was done to evaluate the outcome and safety of the minimal invasive cardiac surgical (MICS) approach using right vertical infra axillary incision (RVAI) for the repair of ASD. Methods: We performed a prospective observational cross-sectional analysis on 50 patients who were diagnosed as ASD of various types and not amenable to device closure. Their surgery was done RVAI using central cardiopulmonary bypass. Outcome of the study was evaluated using the following variables: length of the incision, satisfaction of patients, mortality, infection of surgical site, blood transfusion, duration of total operation, intensive care unit (ICU) stay, mechanical ventilation, hospital stay and aortic occlusion. Operations were done between December 2013 to December 2020. All the recruited patients were treated through RVAI as per patient’s choice. Results: Mean age was 11.4± 6.4 years. 18(36%) were male and 32(64%) were female. Body weight ranged from 10 to 65 kg. Mean length of incision was 6.2±0.8 cm. Mean aortic occlusion time was 42±14 min. ASD closed directly, using autologous treated pericardial patch or dacron patch. Mean total operation time was 4.08±0.6 hours and mean mechanical ventilation time was 8.3±5 hours. Average ICU stay was 35.6±6 hours and total hospital stay was 7.2±0.9 days. There was no significant blood loss. Only 10 patients required intravenous (IV) analgesics in the post-operative period. One patient required re-exploration, one conversion to median sternotomy and one suffered from superficial skin infection. There were no operative or late mortalities. Patient satisfaction was excellent. Conclusions: MICS technique using RVAI for surgical repair of ASD revealed a safe procedure and could be performed with excellent cosmetic and clinical outcomes. It provided a good alternative to the standard median sternotomy. Cardiovasc j 2021; 14(1): 37-43

scholarly journals Comparison between minimal right vertical infra-axillary thoracotomy and standard median sternotomy for repair of atrial septal defects

2015 ◽  
Vol 38 (4) ◽  
pp. 199-204 ◽  
Author(s):  
Hafize Yaliniz ◽  
Mehmet Sah Topcuoglu ◽  
Ugur Gocen ◽  
Atakan Atalay ◽  
Vecih Keklik ◽  
...  
Keyword(s):  
Median Sternotomy ◽  
Septal Defects ◽  
Atrial Septal Defects

scholarly journals A meta-analysis of prospective studies comparing the results of laminoplasty and laminectomy with instrumental fixation in the surgical treatment of patients with multilevel degenerative cervical spine diseases

2020 ◽  
Vol 75 (1) ◽  
pp. 54-68
Author(s):  
Vadim A. Byvaltsev ◽  
Andrey A. Kalinin ◽  
Marat A. Aliev ◽  
Valeriy V. Shepelev ◽  
Bobur R. Yusupov ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Cervical Spine ◽  
Surgical Treatment ◽  
Perioperative Complications ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Random Effect ◽  
Cochrane Library ◽  
Continuous Variables ◽  
Degenerative Diseases

Background: Dorsal decompressive-stabilizing techniques laminotomy with laminoplasty (LP) and laminectomy with instrumental fixation (LF) are effective methods for surgical treatment of patients with multi-level degenerative diseases of the cervical spine. At the same time, there is currently no priority in determining the optimal method for posterior decompression and stabilization. Aim: conduct a comparative analysis of intraoperative parameters, clinical outcomes, radiological results and complications of LP and LF in the treatment of patients with multilevel degenerative diseases of the cervical spine. Methods: A meta-analysis of prospective cohort clinical trials was carried out, the primary sources were searched using the databases PubMed, CNKI, eLibrary and the Cochrane Library, published until March 2019, which compared the results of applying the LP and LF methods in the treatment of patients with multilevel degenerative diseases of the cervical spine. For dichotomous variables, the relative risk and the 95% confidence interval were calculated; in turn, for the continuous variables, the standardized difference of the mean values and their 95% confidence intervals were used, using random effect models and a fixed effect. Resuts: The meta-analysis included 6 prospective clinical trials, one of which was a randomized controlled trial. In total, the results of surgical treatment of 493 patients with multilevel degenerative diseases of the cervical spine were evaluated. In the group of drugs, statistically significantly smaller parameters of the duration of surgical intervention were verified (p 0.00001). At the same time, comparable parameters of cervical lordosis after surgery, the level of pain in the cervical spine, functional status according to NDI and JOA after surgery, the frequency of perioperative complications (p = 0.17, p = 0.05, p = 0.94, p = 0.96, p = 0.24, respectively). Conclusions: A meta-analysis showed that the functional outcomes of LP and LF, as well as instrumental results in the treatment of multilevel degenerative diseases of the cervical spine, are not clinically significant. In this case, the LP technique can be performed in a shorter period of time compared with LF.

scholarly journals Comparison of initial outcomes between minimally invasive right minithoracotomy and standard median sternotomy in patients undergoing isolated surgical closures of atrial septal defects.

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Sumsul Arif Mohammad Musa ◽  
Mauin Uddin ◽  
Syed Al Nahian ◽  
Mohammad Parvez Ahmed ◽  
Saikat Das Gupta ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Median Sternotomy ◽  
Septal Defects ◽  
Atrial Septal Defects

Transcatheter versus surgical closure of atrial septal defects: a systematic review and meta-analysis of clinical outcomes

2021 ◽  
pp. 1-9
Author(s):  
Aimee-Louise Chambault ◽  
Kathryn Olsen ◽  
Louise J. Brown ◽  
Sophie L. Mellor ◽  
Nilofer Sorathia ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Hospital Stay ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Mean Difference ◽  
Complication Rates ◽  
Surgical Closure ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Significant Difference

Abstract Background: Atrial septal defects are a common form of CHD and dependent on the size and nature of atrial septal defects, closure may be warranted. The paper aims to compare outcomes of transcatheter versus surgical repair of atrial septal defects. Methods: A comprehensive electronic literature search was conducted. Primary studies were included if they compared both closure techniques. Primary outcomes included procedural success, mortality, and reintervention rate. Secondary outcomes included residual defect and mean hospital stay. Results: A total of 33 studies were included in meta-analysis. Mean total hospital stay was significantly shorter in the transcatheter cohort across both the adult (95% confidence interval, mean difference −4.05 (−4.78, −3.32) p < 0.00001) and paediatric populations (95% confidence interval, mean difference −4.78 (−5.97, −3.60) p < 0.00001). There were significantly fewer complications in the transcatheter group across both the adult (odds ratio 0.45, 95% confidence interval, [0.28, 0.72], p < 0.00001) and paediatric cohorts (odds ratio 0.26, 95% confidence interval, [0.14, 0.49], p < 0.00001). No significant difference in overall mortality was found between transcatheter versus surgical closure across the two groups, adult (odds ratio 0.76, 95% confidence interval, [0.40, 1.45], p = 0.41), paediatrics (odds ratio 0.62, 95% confidence interval, [0.21, 1.83], p = 0.39). Conclusion: Both transcatheter and surgical approaches are safe and effective techniques for atrial septal defect closure. Our study has demonstrated the benefits of transcatheter closure in terms of lower complication rates and mean hospital stay. However, surgery still has a place for more complex closure and, as we have demonstrated, shows no difference in mortality.

Sacrospinous hysteropexy – an alternative in primary surgical treatment of apical compartment prolapse

2021 ◽  
Vol 86 (3) ◽  
pp. 200-204
Author(s):  
Prokop Homola ◽  
◽  
Germund Hensel ◽  
Milan Košťál
Keyword(s):  
Surgical Treatment ◽  
Pelvic Organ Prolapse ◽  
Operation Time ◽  
Pelvic Organ ◽  
Complication Rates ◽  
Female Population ◽  
Sacrospinous Hysteropexy ◽  
Pubmed Database ◽  
Common Diagnosis ◽  
Apical Compartment

Summary Objective: To present a surgical treatment of pelvic organ prolapse and its outcomes according to the literature. Methods: PubMed database search. Conclusion: Pelvic organ prolapse is a common diagnosis with prevalence around 40% of female population. Vaginal delivery, especially with levator ani trauma, increasing age and obesity are the basic risk factors. Native tissue repair is a possible surgical treatment. Unfortunately, concomitant hysterectomy is still a very common procedure. It is established that uterus plays a passive role in pelvic organ prolapse. Sparing of the uterus keeps the original fixation structures and compartments intact and provides a solid tissue to anchor the stitches. Patients with benign and malign uterine diseases cannot have their uterus spared. In sacrospinous hysteropexy, nonabsorbable sutures are passed through the namesaked ligament on one or both sides to elevate the uterus. Several studies and their metaanalyses show comparable anatomical and functional outcomes with shorter operation time, decreased blood loss, faster recovery and lower complication rates in comparison with hysterectomy and uterosacral ligament fixation. In a prospective randomized control trial, sacrospinous hysteropexy provides significantly lower reoperation rate for apical compartment prolapse in a long-term follow-up. It is a safe and effective procedure for patients who wish to keep their uterus in place. Sacrospinous hysteropexy is an alternative in primary surgical treatment of pelvic organ prolapse.

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