Over 3,000 Minimally Invasive Thoracotomies From the European Congenital Heart Surgeons Association for Quality Repairs of the Most Common Congenital Heart Defects: Safe and Routine for Selected Repairs.

BackgroundMinimally invasive thoracotomies to repair selected congenital heart defects are considered only a cosmetic alternative approach by many; however, they represent the routine alternative in centers of expertise.MethodsPooled institutional data from the European Congenital Heart Surgeons Association using mini-thoracotomy approaches were analyzed since the beginning of their respective experiences until an inclusion surgical date of January 31, 2024, allowing at least six months postoperative follow-up.ResultsFrom 1999 to 2024, 3,007 patients from 11 centers underwent surgery. Age and weight ranged from 4 days to 73 years and 3.1 to 106 kg, respectively. Repaired defects included atrial and ventricular septal defects, partial anomalous pulmonary venous return, partial and complete atrioventricular septal defects, double-chambered right ventricle, cor triatriatum, scimitar syndrome, subaortic stenosis, and total anomalous pulmonary venous return (TAPVR). There was no surgical mortality or intraoperative conversion to sternotomy. Complications included wound infections (0.59%), pacemaker requirement (0.23%), phrenic nerve injury (0.26%), bleeding requiring exploration (0.13%), and neurologic injury (0.29%). Early or late reoperations were needed in 0.73%.ConclusionMinimally invasive thoracotomies are the preferred approach for selected congenital heart defects in the participating pediatric heart centers. Mini-thoracotomy incisions allow safe access to an ever-expanding spectrum of quality repairs, low morbidity, superior cosmetics, and early return to functionality in infants, children, and adults.