Department of Cardiac Surgery, Liaocheng People's Hospital, Liaocheng, Shandong, China.
J Thorac Cardiovasc Surg. 2011 Jun;141(6):1380-3. doi: 10.1016/j.jtcvs.2010.10.028. Epub 2010 Dec 18.
The recent advent of robotically assisted surgery has enabled totally endoscopic repair of atrial septal defects and patent foramen ovale. This study investigates the feasibility and safety of totally endoscopic repair of an atrial septal defect through small incisions on the chest without robotic assistance.
Forty patients (23 female patients; average age, 15.4 ± 8.7 years; age range, 6-47 years) with secundum-type ASDs were selected for this study. Cardiopulmonary bypass was achieved peripherally. Through 3-port incisions in the right chest, pericardiotomy, bicaval occlusion, atriotomy, and ASD repair were performed by a surgeon through a thoracoscopy.
The cardiopulmonary bypass and aortic crossclamp times were 56.2 ± 21.1 and 38.3 ± 8.6 minutes, respectively. The length of stay in the intensive care unit was 23.0 ± 4.1 hours. There were no mortalities and no major complications in this cohort. Patients were discharged from the hospital 4 to 6 days after the operation. Transesophageal echocardiographic analysis immediately after the operation and at 30 days showed complete closure of the defect without residual shunt.
Totally endoscopic atrial septal defect repair can be achieved without a robotically assisted surgical system. This technique is safe and effective and can be used as a therapeutic option for ASD.
机器人辅助手术的出现使得完全经内镜房间隔缺损和卵圆孔未闭修补成为可能。本研究旨在探讨在无机器人辅助的情况下，通过胸部小切口行完全经内镜房间隔缺损修补术的可行性和安全性。
本研究纳入了 40 名（23 名女性患者；平均年龄 15.4 ± 8.7 岁；年龄范围 6-47 岁）继发孔型房间隔缺损患者。采用外周心肺转流。通过右侧胸部的 3 个切口、心包切开术、双腔静脉阻断、心房切开术和房间隔缺损修补术，由外科医生通过胸腔镜完成。
体外循环和主动脉阻断时间分别为 56.2 ± 21.1 分钟和 38.3 ± 8.6 分钟。重症监护病房的住院时间为 23.0 ± 4.1 小时。本队列中无死亡病例和重大并发症。术后 4-6 天患者出院。术后即刻和 30 天经食管超声心动图分析显示，缺损完全闭合，无残余分流。
无需机器人辅助手术系统即可实现完全经内镜房间隔缺损修补术。该技术安全有效，可作为房间隔缺损的治疗选择。
