scholarly journals Individualized strategy of minimally invasive cardiac surgery in congenital cardiac septal defects

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Jiaquan Zhu ◽  
Yunjiao Zhang ◽  
Chunrong Bao ◽  
Fangbao Ding ◽  
Ju Mei
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Septal Defect ◽  
Median Sternotomy ◽  
Right Ventricular Outflow Tract ◽  
Anterolateral Thoracotomy ◽  
Septal Defects ◽  
The Right ◽  
Residual Lesions

Abstract Background Intracardiac septal defect is repaired using median sternotomy in most centers; however, there are several reports using minimally invasive surgery in both children and adults. This study summarized our strategy of minimally invasive therapy using various lateral mini-thoracotomies in patients with congenital septal defect. Methods In this study, 472 patients who underwent minimally invasive repair of intracardiac septal defects (atrial septal defect, (ASD), ventricular septal defect, (VSD), and atrioventricular septal defect, (AVSD)) from January 2012 to June 2020 were retrospectively reviewed. Those who underwent device closure were excluded. The minimally invasive strategy included three groups: the right sub-axillary vertical incision (RSAVI) group (N = 335, including192 ASDs, 135 VSDs and 8 AVSDs); the right anterolateral thoracotomy (RALT) group (N = 132, including 77 ASDs, 51 VSDs and 4 AVSDs); and the left anterolateral thoracotomy (LALT) group (N = 5, all subpulmonary VSDs). Results Concomitant surgeries included nine cases of right ventricular outflow tract obstruction relief, nine cases of mitral repairs and 37 cases of tricuspid repairs. There was one transition from thoracotomy to sternotomy. Three patients required second pump run for residual lesions (two residual VSD shunts and one mitral regurgitation). The age and body weight of the RSAVI group were significantly lower than those of the RALT and LALT groups (all P < 0.01). No postoperative death was observed. Postoperative complications included one case of chest exploration for bleeding, one case of reoperation due to patch dehiscence during the same admission, one case of transient neural dysfunction, three cases of diaphragmatic paresis and 13 cases of atelectasis. The median stay in the intensive care unit was two days, while the median postoperative hospitalization duration was six days. The echocardiography results before discharge indicated no significant residual lesions. No reoperation, no new onset of chest deformities and no sclerosis were observed during the follow-up. Conclusions Intracardiac septal defects can be safely and effectively repaired by minimally invasive surgery with good cosmetic results. RSAVI is suitable in infants and children, while RALT is more commonly used in adolescents and adults. LALT is an alternative incision to repair subpulmonary VSD.

scholarly journals Individualized Strategy of Minimally Invasive Cardiac Surgery in Congenital Cardiac Septal Defects

2021 ◽  
Author(s):  
Jiaquan Zhu ◽  
Yunjiao Zhang ◽  
Chunrong Bao ◽  
Fangbao Ding ◽  
Ju Mei
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Septal Defect ◽  
Right Ventricular Outflow Tract ◽  
Anterolateral Thoracotomy ◽  
Septal Defects ◽  
Vertical Incision ◽  
Residual Lesions ◽  
Mini Thoracotomy

Abstract Background: Intracardiac septal defect tends to be repaired by minimally invasive surgery in both children and adults. This study summarized our strategy of minimally invasive therapy using various lateral mini-thoracotomies in patients with congenital septal defect. Methods: Four hundred and seventy-two patients who underwent minimally invasive repair of intracardiac septal defects (Atrial septal defect, ASD; ventricular septal defect, VSD; atrioventricular septal defect, AVSD) between January 2012 and June 2020 were retrospectively reviewed. Those who underwent device closure were excluded. The minimally invasive strategy included three groups. First, right sub-axillary vertical incision group (RSAVI group, N=335, 192 ASDs, 135 VSDs and 8 AVSDs; Second, right anterolateral thoracotomy group (RALT group, N=132, 77 ASDs, 51 VSDs and 4 AVSDs; Third, left anterolateral thoracotomy group (LALT group, N=5, all of them were sub-pulmonary VSDs).Results: Concomitant surgeries included 9 cases of right ventricular outflow tract obstruction relief, 9 mitral repairs and 37 tricuspid repairs. There was one transition from thoracotomy to sternotomy. Three patients required second pump run for residual lesions (2 residual shunts and 1 mitral regurgitation). The age and body weight of RSAVI group were significantly lower than those of RALT and LALT groups. The mean cardiopulmonary bypass time was 67.3±11.3 min and cross clamp time was 38.1±8.9 min. There was no post-operative death, and complications included 1 chest exploration for bleeding, 1 redo operation due to patch dehiscence during the same admission, 1 transient neural dysfunction, 3 diaphragmatic paresis and 13 atelectasis. The median stay in ICU was 2 days, while the median post-operative hospitalization was 6 days. The echocardiography results before discharge indicated no significant residual lesions. There was no reoperation, no new onset of chest deformities and no sclerosis during the follow up. Conclusions: The commonly seen intracardiac septal defects can be safely and effectively repaired by minimally invasive surgery with good cosmetic results. Right sub-axillary vertical incision is suitable in infants and young children, while right anterior mini-thoracotomy is more commonly used in adolescents and adults. Left anterior mini-thoracotomy is an alternative incision to repair sub-pulmonary artery VSD.

Minimally Invasive Pulmonary Fibroelastoma Resection

2019 ◽  
Vol 14 (6) ◽  
pp. 577-580 ◽  
Author(s):  
Joseph R. Nellis ◽  
Charles M. Wojnarski ◽  
Zachary W. Fitch ◽  
Nicholas A. Andersen ◽  
Joseph W. Turek
Keyword(s):  
Minimally Invasive ◽  
Main Pulmonary Artery ◽  
Tumor Resection ◽  
Median Sternotomy ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Postoperative Recovery ◽  
Pulmonary Valve Replacement ◽  
Primary Cardiac Tumor ◽  
The Right

Pulmonary fibroelastomas are a rare primary cardiac tumor with less than 50 cases reported in the literature to date. We performed a minimally invasive valve-sparing tumor resection through a left anterior mini-incision (LAMI). The procedure was performed without cardiac arrest or aortic cross clamp, expediting postoperative recovery and allowing for an uncomplicated discharge on postoperative day 5. LAMI is a safe and reliable alternative to median sternotomy for patients requiring interventions on the right ventricular outflow tract and main pulmonary artery, including pulmonary fibroelastoma resection and pulmonary valve replacement when needed.

scholarly journals Robotic assisted minimally invasive surgery for atrial septal defect correction

2012 ◽  
Vol 27 (3) ◽  
pp. 488-490 ◽  
Author(s):  
Robinson Poffo ◽  
Alex Luiz Celullare ◽  
Renato Bastos Pope ◽  
Alisson Parrilha Toschi
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Atrial Septal Defect ◽  
Invasive Surgery ◽  
Septal Defect ◽  
Defect Correction ◽  
Robotic Assisted

scholarly journals Right Anterolateral Thoracotomy an Alternative to Median Sternotomy for Closure of Atrial Septal Defect: A Cosmetic Approach in Young Females

2015 ◽  
Vol 12 (1) ◽  
pp. 21-25
Author(s):  
Ravi Kumar Baral ◽  
Bhagawan Koirala
Keyword(s):  
Minimally Invasive ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Demographic Data ◽  
Median Sternotomy ◽  
Young Females ◽  
Anterolateral Thoracotomy ◽  
Significant Difference ◽  
Asd Closure ◽  
Duration Of Operation

Background and Aims: Atrial septal defect operation is a safe and low-risk procedure. Cosmetic results have been an important issue, so right anterolateral thoracotomy approach has been used for repair. We present minimally invasive ASD closure via limited right anterolateral thoracotomy, as our early experience in road of minimally invasive cardiac surgery. Methods: This study was done in the Manmohan Cardiothoracic and Transplant Center in the time period of 2012 to 2013. The study included 70 patients aged 15 – 35 years old (22.1±5.5) admitted for surgical repair of their secundum atrial septal defects. The patients were randomly allocated into one of two groups according to the approach used in their operation. Right anterolateral thoracotomy(RALT) group included 35 patients operated via right anterolateral thoracotomy.and median sternotomy(MS) group included 35 patients operated via the median sternotomy. Result: Of 70 patients only 63 patients meet the criteria for analysis. There was no statistically significant difference between the 2 groups regarding their demographic data and duration of operation. Postoperative pleural/pericardial effusion and pneumothorax occurred in 2.1% of patients in MS and 6.6% in Right anterolateral thoracotomygroup (p= 0.001). Total in hospital pain score was high in sternotomy group than thoracotomy group, but did not reach statistically significant values. There was no operative or late mortality or morbidity in the early follow-up (range, 1 m to 2 years, mean 1.34 yrs). Conclusion: RALT is a safe and effective alternative approach to MS incision for ASD closure. DOI: http://dx.doi.org/10.3126/njh.v12i1.12340 Nepalese Heart Journal Vol.12(1) 2015: 21-25

scholarly journals Variation in medical management and neurosurgical treatment of patients with supratentorial spontaneous intracerebral haemorrhage

2021 ◽  
pp. 239698732110059
Author(s):  
Lotte Sondag ◽  
Floor AE Jacobs ◽  
Floris HBM Schreuder ◽  
Jeroen D Boogaarts ◽  
W Peter Vandertop ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Intracerebral Haemorrhage ◽  
Online Survey ◽  
Treatment Decisions ◽  
Neurosurgical Treatment ◽  
The Right ◽  
Invasive Techniques ◽  
Spontaneous Intracerebral Haemorrhage

Introduction The role of surgery in spontaneous intracerebral haemorrhage (sICH) remains controversial. This leads to variation in the percentage of patients who are treated with surgery between countries. Patients and methods We sent an online survey to all neurosurgeons (n = 140) and to a sample of neurologists (n = 378) in Dutch hospitals, with questions on management in supratentorial sICH in general, and on treatment in six patients, to explore current variation in medical and neurosurgical management. We assessed patient and haemorrhage characteristics influencing treatment decisions. Results Twenty-nine (21%) neurosurgeons and 92 (24%) neurologists responded. Prior to surgery, neurosurgeons would more frequently administer platelet-transfusion in patients on clopidogrel (64% versus 13%; p = 0.000) or acetylsalicylic acid (61% versus 11%; p = 0.000) than neurologists. In the cases, neurosurgeons and neurologists were similar in their choice for surgery as initial treatment (24% and 31%; p = 0.12), however variation existed amongst physicians in specific cases. Neurosurgeons preferred craniotomy with haematoma evacuation (74%) above minimally-invasive techniques (5%). Age, Glasgow Coma Scale score and ICH location were important factors influencing decisions on treatment for neurosurgeons and neurologists. 69% of neurosurgeons and 80% of neurologists would randomise patients in a trial evaluating the effect of minimally-invasive surgery on functional outcome. Discussion Our results reflect the lack of evidence about the right treatment strategy in patients with sICH. Conclusion New high quality evidence is needed to guide treatment decisions for patients with ICH. The willingness to randomise patients into a clinical trial on minimally-invasive surgery, contributes to the feasibility of such studies in the future.

Minimally Invasive Surgery for Congenital Atrial Septal Defects vs. Catheter Based Device-Occlusion in Adults

2015 ◽  
Vol 63 (S 01) ◽  
Author(s):  
Y. Schneeberger ◽  
A. Schaefer ◽  
J. Brickwedel ◽  
T. Deuse ◽  
H. Treede ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Septal Defects ◽  
Atrial Septal Defects

scholarly journals Minimally invasive surgery for atrial septal defects: a 20-year experience at a single centre

2019 ◽  
Vol 28 (6) ◽  
pp. 961-967 ◽  
Author(s):  
Vladimiro L Vida ◽  
Lorenza Zanotto ◽  
Lucia Zanotto ◽  
Chiara Tessari ◽  
Massimo A Padalino ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Single Centre ◽  
Septal Defects ◽  
Atrial Septal Defects

scholarly journals A case of maxillary bone metastasis from lung cancer

2015 ◽  
Vol 5 (4) ◽  
Author(s):  
Takeshi Kusunoki ◽  
Hirotomo Homma ◽  
Yoshinobu Kidokoro ◽  
Aya Yanai ◽  
Katsuhisa Ikeda ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Minimally Invasive Surgery ◽  
Bone Metastasis ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Maxillary Bone ◽  
Old Japanese ◽  
History Of ◽  
The Right ◽  
End Stage

We experienced a very rare case of maxillary bone metastasis from lung cancer. The patient was a 77-year-old Japanese man with 1-month history of right alar swelling with hard pain as his chief complaint. Computed tomography scan showed a 1 cm length round lesion in the right nasal vestibule close to the pyriform fossa edge of the right maxillary bone. He had severe pulmonary dysfunction due to recurrent end stage lung cancer and diabetes. The expected remainder of his life would be half a year. Therefore, his very poor condition precluded general anesthesia. To relieve the nasal pain, shorten the stay in the hospital and improve the quality of life (QOL), we performed minimally invasive surgery under local anesthesia. Our minimally invasive surgery could improve QOL by relieving the hard nasal pain until the recurrence of cancer and enable the patient to live at home.

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