Totally thoracoscopic repair of atrial septal defect: A single-center clinical study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LAN Huai ¹ , CHENG Yunge ² ,  JIA Baocheng ² , CHAI Yuliang ²

1. Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, Shenyang, 110016, P.R.China;
2. Department of Thoracoscopic Cardiac Surgery, Shanghai Yodak Cardiothoracic Hospital, Shanghai, 200235, P.R.China;

Corresponding?author：

JIA Baocheng, Email: jiabaocheng@126.com

Keywords：

Thoracoscopy; minimally invasive cardiac surgery; atrial septal defect

DOI：

10.7507/1007-4848.201904044

Video：

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Objective To summarize the experience of totally thoracoscopic cardiac surgery (TTCS) for atrial septal defect.Methods Clinical data of 442 patients undergoing TTCS for atrial septal defect from May 2008 to December 2018 in Shanghai Yodak Cardiothoracic Hospital was analyzed retrospectively. There were 149 male and 293 female patients, aged 3-74 (29.1±14.3) years. Surgical procedures were performed through 3 ports at the right chest wall.Results All the operations were completed successfully. Mean operative time was 1.5-4.6 (2.2±0.3) h. The mean extracorporeal circulation and aortic cross-clamp time was 28-118 (55.9±13.3) min and 8-78 (21.5±10.2) min, respectively. Mechanical ventilation and intensive care unit stay time was 3.5-122.0 (8.1±7.4) h and 13-141 (20.7±10.2) h, respectively. Postoperation drainage volume was 70-1 280 (251.8±131.5) mL. The hospital stay was 4-16 (7.1±1.4) d. Intraoperative and postoperative complications occurred in 15 patients (3.3%). The mean follow-up time was 1-128 (67.6±33.3) months, and during the period, there were 25 patients of atrial fibrillation, 25 patients of mild-moderate tricuspid valve incompetence, 1 patient of moderate tricuspid valve incompetence. There was no reoperation or residual shunt during the period of follow-up. And the heart function was improved.Conclusion TTCS is a feasible, safe and minimal invasive approach for patients with atrial septal defect and has good short to medium-term outcomes.

Citation： LAN Huai, CHENG Yunge, JIA Baocheng, CHAI Yuliang. Totally thoracoscopic repair of atrial septal defect: A single-center clinical study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(3): 264-267. doi: 10.7507/1007-4848.201904044 Copy

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9.	鄧友明, 張維峰, 趙秀芳, 等. 小潮氣量快頻率間歇正壓通氣在全胸腔鏡下心臟手術中的應用. 中國微創外科雜志, 2014, 14(6): 481-483.
10.	襲潔, 馬增山, 孫厚榮, 等. 200例全胸腔鏡下心臟手術的體外循環管理. 中國體外循環雜志, 2016, 14(2): 83-86.
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13.	張曉慎, 劉菁, 陳寄梅, 等. 全胸腔鏡下體外循環三尖瓣成形外科手術. 實用醫院臨床雜志, 2016, 13(1): 7-10.
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1. 程云閣, 王躍軍, 張泉, 等. 完全胸腔鏡下體外循環心臟手術674例臨床分析. 中華外科雜志, 2007, 45(22): 1521-1523.
2. Cheng Y, Wang Y, Wang W, et al. Totally endoscopic atrial septal defect repair through 3 ports. Heart Surg Forum, 2008, 11(5): E285-289.
3. Cheng Y, Cheng H, Mohl W, et al. Totally endoscopic congenital heart surgery compared with the traditional heart operation in children. Wien Klin Wochenschr, 2013, 125(21-22): 704-708.
4. 王躍軍, 程云閣, 王維俊, 等. 全胸腔鏡下手術治療先天性心臟病. 中國微創外科雜志, 2009, 9(5): 404-406.
5. 程云閣, 肖明第, 賈寶成, 等. 完全胸腔鏡下二尖瓣手術272例. 中華胸心血管外科雜志, 2012, 28(4): 198-199.
6. 蘭懷, 程云閣, 賈寶成, 等. 完全胸腔鏡下二尖瓣置換術634例臨床分析. 中華外科雜志, 2016, 54(8): 609-612.
7. 中國醫師協會心血管外科分會胸腔鏡學術委員會. 胸腔鏡心臟外科手術中國專家共識. 中華胸心血管外科雜志, 2012, 28(4): 193-194.
8. 陳敏, 金振曉, 熊東方, 等. 胸腔鏡心臟手術麻醉中應用小潮氣量較快頻率間歇正壓通氣的可行性. 心臟雜志, 2008, 20(2): 204-206.
9. 鄧友明, 張維峰, 趙秀芳, 等. 小潮氣量快頻率間歇正壓通氣在全胸腔鏡下心臟手術中的應用. 中國微創外科雜志, 2014, 14(6): 481-483.
10. 襲潔, 馬增山, 孫厚榮, 等. 200例全胸腔鏡下心臟手術的體外循環管理. 中國體外循環雜志, 2016, 14(2): 83-86.
11. 龍村, 主編. 體外循環手冊. 北京: 人民衛生出版社, 2013. 24-25.
12. 鄧海青, 杜正隆, 凌毅, 等. 全胸腔鏡下心臟手術的并發癥及防治分析. 中國臨床新醫學, 2010, 3(8): 709-711.
13. 張曉慎, 劉菁, 陳寄梅, 等. 全胸腔鏡下體外循環三尖瓣成形外科手術. 實用醫院臨床雜志, 2016, 13(1): 7-10.
14. Jeong DS, Kim KH. Tricuspid annuloplasty using the MC3 ring for functional tricuspid regurgitation. Circ J, 2010, 74(2): 278-283.
15. 徐學增, 易蔚, 李華, 等. 單中心全胸腔鏡微創手術治療先天性心臟病2543例臨床分析. 中華外科雜志, 2016, 54(8): 591-595.

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Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Totally thoracoscopic repair of atrial septal defect: A single-center clinical study

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