Minimally invasive cardiac surgery with the partial mini-sternotomy in children / 대한흉부외과학회지
The Korean Journal of Thoracic and Cardiovascular Surgery
;
: 466-471, 1998.
Article
in Korean
| WPRIM
| ID: wpr-149701
ABSTRACT
Purpose:
The safety and efficacy of minimally invasive techniques in congenital heart surgery were tested in this study. Materal andmethod:
Between July 1997 and November 1997, a total of 46 children were underwent minimally invasive cardiac operations at Seoul National University Children's Hospital. Age and body weight of the patients averaged 34.6+/-41.8 (Range 1~148) months and 14.5+/-9.9 (Range 3.0~40.0) kg, respectively. Twenty eight patients were male. Preoperative surgical indications included 15 atrial septal defects, 25 ventricular septal defects, 1 foreign body in aorta, 3 partial atrioventricular septal defects, 1 total anomalous pulmonary venous connection (cardiac type), and 1 tetralogy of Fallot. After creating a small lower midline skin incision starting as down as possible from the sternal notch, a vertical midline sternotomy extended from xyphoid process to the level of the second intercostal space, where one of the T-, J-, I-or inverted C-shaped lower lying mini-sternotomy was completed with a creation of unilateral right or bilateral trap door sternal opening. A conventional direct aortic and bicaval cannulation was routine.RESULT:
A mean length of skin incision was 6.1+/-1.0 (range 4.0~9.0) cm. A mean distance between the suprasternal notch and the upper most point of the skin incision was 4.0+/-1.1 (range 2.0~7.0) cm. Mean cardiopulmonary bypass time, aortic cross-clamp time, and the operation time were 62.9+/-20.0 (range 28~147), 29.8+/-12.8 (range 11~79), and 161.1+/-34.5 (range 100-250) minutes. A mean total amount of postoperative blood transfusion was 71.0+/-68.1 (range 0~267) cc. All patients were extubated mean 11.3+/-13.8 (range 1~73) hours after operation. A mean total amount of analgesics used was 0.8+/-1.8 (range 0~9) mg of morphine. The mean duration of stay in intensive care unit and hospital stay were 35.0+/-32.2 (range 10~194) hours and 6.2+/-2.0 (range 3~11) days. There were no wound complications and hospital deaths.CONCLUSION:
This short-term experience disclosed that the minimally invasive technique can be feasibly applied in a selected group of congenital heart disease as well as is cosmetically more attractive approach.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Aorta
/
Skin
/
Tetralogy of Fallot
/
Thoracic Surgery
/
Wounds and Injuries
/
Blood Transfusion
/
Body Weight
/
Catheterization
/
Cardiopulmonary Bypass
/
Minimally Invasive Surgical Procedures
Limits:
Child
/
Humans
/
Male
Country/Region as subject:
Asia
Language:
Korean
Journal:
The Korean Journal of Thoracic and Cardiovascular Surgery
Year:
1998
Type:
Article
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