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.	邓友明, 张维峰, 赵秀芳, 等. 小潮气量快频率间歇正压通气在全胸腔镜下心脏手术中的应用. 中国微创外科杂志, 2014, 14(6): 481-483.
10.	袭洁, 马增山, 孙厚荣, 等. 200例全胸腔镜下心脏手术的体外循环管理. 中国体外循环杂志, 2016, 14(2): 83-86.
11.	龙村, 主编. 体外循环手册. 北京: 人民卫生出版社, 2013. 24-25.
12.	邓海青, 杜正隆, 凌毅, 等. 全胸腔镜下心脏手术的并发症及防治分析. 中国临床新医学, 2010, 3(8): 709-711.
13.	张晓慎, 刘菁, 陈寄梅, 等. 全胸腔镜下体外循环三尖瓣成形外科手术. 实用医院临床杂志, 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.	徐学增, 易蔚, 李华, 等. 单中心全胸腔镜微创手术治疗先天性心脏病2543例临床分析. 中华外科杂志, 2016, 54(8): 591-595.

1. 程云阁, 王跃军, 张泉, 等. 完全胸腔镜下体外循环心脏手术674例临床分析. 中华外科杂志, 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. 王跃军, 程云阁, 王维俊, 等. 全胸腔镜下手术治疗先天性心脏病. 中国微创外科杂志, 2009, 9(5): 404-406.
5. 程云阁, 肖明第, 贾宝成, 等. 完全胸腔镜下二尖瓣手术272例. 中华胸心血管外科杂志, 2012, 28(4): 198-199.
6. 兰怀, 程云阁, 贾宝成, 等. 完全胸腔镜下二尖瓣置换术634例临床分析. 中华外科杂志, 2016, 54(8): 609-612.
7. 中国医师协会心血管外科分会胸腔镜学术委员会. 胸腔镜心脏外科手术中国专家共识. 中华胸心血管外科杂志, 2012, 28(4): 193-194.
8. 陈敏, 金振晓, 熊东方, 等. 胸腔镜心脏手术麻醉中应用小潮气量较快频率间歇正压通气的可行性. 心脏杂志, 2008, 20(2): 204-206.
9. 邓友明, 张维峰, 赵秀芳, 等. 小潮气量快频率间歇正压通气在全胸腔镜下心脏手术中的应用. 中国微创外科杂志, 2014, 14(6): 481-483.
10. 袭洁, 马增山, 孙厚荣, 等. 200例全胸腔镜下心脏手术的体外循环管理. 中国体外循环杂志, 2016, 14(2): 83-86.
11. 龙村, 主编. 体外循环手册. 北京: 人民卫生出版社, 2013. 24-25.
12. 邓海青, 杜正隆, 凌毅, 等. 全胸腔镜下心脏手术的并发症及防治分析. 中国临床新医学, 2010, 3(8): 709-711.
13. 张晓慎, 刘菁, 陈寄梅, 等. 全胸腔镜下体外循环三尖瓣成形外科手术. 实用医院临床杂志, 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. 徐学增, 易蔚, 李华, 等. 单中心全胸腔镜微创手术治疗先天性心脏病2543例临床分析. 中华外科杂志, 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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