Thoracoscopic Correction Of Congenital Septal Heart Defects: Center's Experience
Mukhamedov Ikromzhon,

Joshybaev S.D., Alibekov A.A., Rozbaev Z.N., Kenbaev A.B., Zelentsova A.A., Ukolova Y.N.

Scientific and Clinical Center of Cardiac Surgery and Transplantology, Taraz, Kazakhstan

BACKGROUND

Advancesinendoscopictechnologiesandaccumulatedsurgicalexperiencehavemadethoracoscopiccorrectionofcongenitalheartdefectsincreasinglywidespread,showinggoodoutcomesandlowcomplicationrates.However,reportsonthistechniqueinCentralAsiaarelimited.ThisstudypresentsthefirstexperienceofthoracoscopicclosureofseptaldefectsinKazakhstan.

METHODS

FromAugust2015,120patientsunderwentthoracoscopicclosureofatrial(ASD,n=93)andventricularseptaldefects(VSD,n=27),including82adults(meanage41.5[27-50.8]years,weight62[52.5-69]kg)and38children(meanage13[10-14.5]years,weight39[23.5-49]kg).ASDclosureswereperformedonabeatingheartunderparallelperfusion;VSDcorrectionsusedtheChitwoodaorticcross-clamp.Cardiopulmonarybypass(CPB)wasviaperipheralcannulation,withintraoperativetransesophagealechocardiographymonitoring.

RESULTS

Noin-hospitalmortalityorseverecomplicationsoccurred.Inadults,meansurgerydurationwas230(ASD)and255(VSD)minutes;CPBtime58and101minutes;aorticcross-clampforVSD69.5minutes.Inchildren,surgerylasted240(ASD)and260(VSD)minutes;CPB48and81minutes;aorticcross-clamp64minutes.Bloodlosswasminimal,ICUstayaveraged16hours,andhospitalization6-6.5days.Pre-dischargeechocardiographyshowednoresidualshunts

CONCLUSIONS

Totallythoracoscopicmitralvalvereplacementinadolescentsisafeasibleandsafetechnique.Furtherexperienceandlong-termfollow-uparerequired