Application of self-made bipolar venous cannula in total thoracoscopic operation for atrial septal defect in children / 解放军医学杂志

ABSTRACT

Objective To summarize the feasibility of the application of the self-made bipolar venous cannulae to repair atrial septal defect(ASD)totally through thoracoscope in children.Methods Twenty-eight children,aged 4.2?1.3 years in average and weighed 14.6?3.9kg,were diagnosed as congenital ASD.Among these patients 3 were complicated by moderate to severe pulmonary hypertension,4 by partial pulmonary venous teratosis and 3 by tricuspid valve insufficiency.During the operation,patients were placed in a supine position,and the right shoulder was padded 30? higher than the left.A tracheal cannula was inserted and air was given with high frequency jet ventilation.Three small thoracotomies with a diameter of 2 to 3 cm were made in the 4th intercostal space on the right side of the sternum and the 4th and 7th intercostal spaces on the right middle axillary line.The cardiopulmonary bypass(CPB)was set up through the right femoral artery and femoral vein with bipolar femoral venous cannulae.The ASD was repaired through the thoracoscope.Results In all the 28 patients,the mean extracorporeal circulation time was 53.5?17.8min,and cross-clamp time was 25.2?7.9min.Automatic heart beat recovered after the declamping of the aorta in all the patients.No serious complication occurred.Heart murmur vanished,and ultrasonic examination was negative.Half a year after operation,ECG showed that the size of right ventricle and right atrium became maller in size,the diameter of pulmonary artery diminished,and the cardiac function was improved(P