Minimally invasive small incision surgical repair versus interventional device closure for secundum atrial septal defects / 中国微创外科杂志

ABSTRACT

Objective To compare merits and shortages between minimally invasive small incision surgical repair and interventional device closure for isolated secundum atrial septal defect (ASD). Methods A retrospective analysis was made on clinical results of 69 patients with isolated secundum ASD from January 2004 to June 2006. Among them 37 patients underwent minimally invasive small incision surgical repair on the beating heart (Small Incision Group) and 32 patients underwent interventional device closure of ASD (Interventional Group). Results There were no deaths in either group. The small incision surgical repair was successfully completed in all the 37 patients, with the procedure time, cardiopulmonary bypass time, and hospital stay being 145.86?27.84 min, 35.11?8.45 min, and 15.46?3.09 d, respectively. Major and minor complications occurred in 2 and 6 patients, respectively. The hospitalization costs was 21 900?3600 yuan. In the Interventional Group, the closure was successfully performed in 30 out of 32 patients. The procedure time and hospital stay were 88.59?7.75 min and 10.81?5.02 d, respectively. Major and minor complications occurred in 1 and 2 patients, respectively. The hospitalization costs was 27 800?3900 yuan. Follow-up observations were performed in the Small Incision Group for 3~12 months in 20 patients and for 12~30 months in 17 patients, and in the Interventional Group for 3~12 months in 16 patients and for 12~30 months in 14 patients. No residual shunt was found. Conclusions Both of minimally invasive methods are safe and effective for isolated secundum ASD. Small incision surgical repair involves lower costs, higher successful rate, and broader indications, whereas interventional device closure offers shorter hospital stay, milder trauma, and better cosmetic results.