Video-assisted Thoracoscopic Cardiac Surgery for Congenital Heart Diseases / 中国微创外科杂志

ABSTRACT

Objective To probe the feasibility of video-assisted thoracoscopic operation for congenital heart diseases.Methods From October 2004 to August 2008,156 patients with congenital heart disease,including 79 cases of atrial septal defect(ASD),65 cases of ventricular septal defect(VSD),1 case of aortic aneurysm rupture combined with VSD,3 cases of double chamber right ventricles(DCRV) combined with VSD,and 8 cases of partial anomalous pulmonary venous drainage,were treated totally under thoracoscope.Surgical procedures were performed through 3 trocars inserted at the right chest wall,and catheters were placed in the right femoral artery and vein to set up extracorporeal circulation.The ascending aorta was cross-clamped with long tailor-made forceps and the myocardium was protected by coronary perfusion with cold crystalloid cardioplegia. Results All the thoracoscopic operations were completed successfully.The mean extracorporeal circulation and cross-clamping time were(74?28) min and(29?13) min respectively.Postoperative ventilation was withdrawn in(3.2?1.1) h,and the patients were discharged from the hospital in(6.1?1.2) d.Thirteen of the patients had postoperative complications,including 7 cases of right pneumothorax(healed by thoracentesis),and 6 cases of fat liquefaction of the incision at the right axillary(delayed healing).No severe complications occurred in this series.UCG performed 5-7 days after the operation revealed no residual shunt of ASD or VSD;in the patients who had aortic aneurysm rupture combined with VSD,slight aortic valve regurgitation was detected after the neoplasty;and in the 3 patients with DCRV combined with VSD,the right ventricular outflow tract was patent.ECG showed sinus rhythm without AVB in the patients.Follow-up up to 3 months to 3 years were available in 132 cases(over 12 months in 95 cases).During the period,no patient had complaints;and the heart function was confirmed as level Ⅰ.Conclusions Video-assisted thoracoscopic cardiac surgery is feasible,safe,and minimal invasive for patients with VSD or ASD,resulting in quick recovery and good cosmetic outcomes.