HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Redmond P. Burke Aldo R. Castaneda Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Burke, R. P. Articles by Castaneda, A. R. Search for Related Content PubMed PubMed Citation Articles by Burke, R. P. Articles by Castaneda, A. R.

J Thorac Cardiovasc Surg 1995;109:499-508
© 1995 Mosby, Inc.

SURGERY FOR CONGENITAL HEART DISEASE

Video-assisted thoracoscopic surgery for congenital heart disease

Boston, Mass.

From the Departments of Cardiology, Anesthesia, and Cardiovascular Surgery, Children's Hospital, Departments of Pediatrics, Anesthesia, and Surgery, Harvard Medical School, Boston, Mass.

Address for reprints: Redmond P. Burke, MD, Department of Cardiac Surgery, The Children's Hospital, 300 Longwood Ave., Boston, MA 02115.

Abstract

Video-assisted endoscopic techniques have reduced operative trauma in adult thoracic and general surgery, but applications in children with congenital heart disease have been limited. We report the development of video-assisted thoracic surgery procedures for neonates and infants with cardiovascular disease. Endoscopic instruments and techniques for pediatric cardiovascular procedures were designed and tested in the animal laboratory. Forty-eight operations were subsequently performed in 46 pediatric patients ranging in age from 2 hours to 14 years (median 9 months), weighing from 575 grams to 54 kg (median 8.5 kg). Clinical applications included seven different procedures: patent ductus ateriosus interruption in infants (n = 26) and premature neonates (n = 5), vascular ring division (n = 8), pericardial drainage and resection (n = 3), arterial and venous collateral interruption (n = 2), thoracic duct ligation (n = 2), epicardial pacemaker lead insertion (n = 1), and diagnostic thoracoscopy ( n = 1), and diagnostic thoracoscopy (n = 1). there was no operative mortality. Technical success, defined as a video-assisted procedure completed without incising chest wall muscle or spreading the ribs, was achieved in 39 of 48 procedures (82%), with thoracotomy required to complete nine procedures. Most patients (22/25, 88%) undergoing elective ductus ligation were extubated in the operating room and discharged from the hospital within 48 hours of the operation. Eight of the last 10 patients having ductus ligation were discharged on the first postoperative day. Residual ductal flow was assessed by (1) transesophageal echocardiography in the operating room (incidence: 0/25, 0%, 70% CL 0% to 7.3%); (2) discharged auscultation (incidence: 1/30, 3%, 70% CL 0.5% to 10.8%); and (3) follow-up Doppler echocardiography (incidence: 1/30, 3%, 70% CL 5.4% to 22.6%). Video-assisted thoracoscopic techniques can be safely applied to pediatric patients with patent ductus arteriosus and vascular rings and may become an effective addition to the staged management of more complex forms of congenital heart disease. (J THORAC CARDIOVASC SURG 1995; 109: 499-508)

This article has been cited by other articles:

				D. S. Nath, J. Savla, R. G. Khemani, D. P. Nussbaum, C. L. Greene, and W. J. Wells Thoracic duct ligation for persistent chylothorax after pediatric cardiothoracic surgery. Ann. Thorac. Surg., July 1, 2009; 88(1): 246 - 252. [Abstract] [Full Text] [PDF]

				A. M. Gaca, J. J. Jaggers, L. T. Dudley, and G. S. Bisset III Repair of Congenital Heart Disease: A Primer--Part 2 Radiology, July 1, 2008; 248(1): 44 - 60. [Abstract] [Full Text] [PDF]

				E. Villa, F. V. Eynden, E. Le Bret, T. Folliguet, and F. Laborde Paediatric video-assisted thoracoscopic clipping of patent ductus arteriosus: experience in more than 700 cases Eur. J. Cardiothorac. Surg., March 1, 2004; 25(3): 387 - 393. [Abstract] [Full Text] [PDF]

				J. P. Jacobs, J. M. Giroud, J. A. Quintessenza, V. O. Morell, L. M. Botero, H. M. van Gelder, V. Badhwar, and R. P. Burke The modern approach to patent ductus arteriosus treatment: complementary roles of video-assisted thoracoscopic surgery and interventional cardiology coil occlusion Ann. Thorac. Surg., November 1, 2003; 76(5): 1421 - 1428. [Abstract] [Full Text] [PDF]

				T. Mihaljevic, J. W. Cannon, and P. J. del Nido Robotically assisted division of a vascular ring in children J. Thorac. Cardiovasc. Surg., May 1, 2003; 125(5): 1163 - 1164. [Full Text] [PDF]

				A. Giamberti, E. Mazzera, L. Di Chiara, E. Ferretti, L. Pasquini, and R.M. Di Donato Right submammary minithoractomy for repair of congenital heart defects Eur. J. Cardiothorac. Surg., December 1, 2000; 18(6): 678 - 682. [Abstract] [Full Text] [PDF]

				K. Miyaji, R. L. Hannan, J. Ojito, J. M. Dygert, J. A. White, and R. P. Burke Video-assisted cardioscopy for intraventricular repair in congenital heart disease Ann. Thorac. Surg., September 1, 2000; 70(3): 730 - 737. [Abstract] [Full Text] [PDF]

				K. Miyaji, R. L. Hannan, J. W. Ojito, J. A. White, and R. P. Burke Minimally invasive resection of congenital subaortic stenosis Ann. Thorac. Surg., April 1, 2000; 69(4): 1273 - 1275. [Abstract] [Full Text] [PDF]

				K. Kirali, M. Guler, B. Daglar, G. Ipek, M. Balkanay, E. Akinci, T. Berki, A. Gurbuz, O. Isik, and C. Yakut Videothoracoscopic Internal Mammary Artery Harvest for Coronary Bypass Asian Cardiovasc Thorac Ann, December 1, 1999; 7(4): 259 - 262. [Abstract] [Full Text] [PDF]

				J.Q. Melo, J.P. Neves, M. Abecassis, and M.M. Pinto Cava endoluminal balloon occlusion as an adjunct technique to perform less invasive cardiopulmonary bypass procedures Eur. J. Cardiothorac. Surg., November 1, 1999; 16(suppl_2): S89 - S92. [Abstract] [Full Text] [PDF]

				D. R Watson and S. B Duff The clinical and financial impact of port-access coronary revascularization Eur. J. Cardiothorac. Surg., September 1, 1999; 16(suppl_1): S103 - S106. [Abstract] [Full Text] [PDF]

				H. J.C.M. van de Wal, M. Barbero-Marcial, S. Hulin, and Y. Lecompte Cardiac surgery by transxiphoid approach without sternotomy Eur. J. Cardiothorac. Surg., May 1, 1999; 13(5): 551 - 554. [Abstract] [Full Text] [PDF]

				M. Massetti, G. Babatasi, A. Lotti, S. Bhoyroo, O. Le Page, and A. Khayat Less-invasive heart surgery: the preservation of median approach Eur. J. Cardiothorac. Surg., October 1, 1998; 14(suppl_1): S138 - S142. [Abstract] [Full Text] [PDF]

				M. H. Hines, A. S. Bensky, J. W. Hammon Jr, and D. G. Pennington Video-assisted thoracoscopic ligation of patent ductus arteriosus: safe and outpatient Ann. Thorac. Surg., September 1, 1998; 66(3): 853 - 859. [Abstract] [Full Text] [PDF]

				M. Massetti, G. Babatasi, A. Lotti, S. Bhoyroo, O. Le Page, and A. Khayat Less invasive cardiac operations through a median sternotomy: 100 consecutive cases Ann. Thorac. Surg., September 1, 1998; 66(3): 1050 - 1054. [Abstract] [Full Text] [PDF]

				D. F. Loulmet, A. Carpentier, P. W. Cho, A. Berrebi, N. d'Attellis, C. B. Austin, J.-P. Couetil, and P. Lajos Less invasive techniques for mitral valve surgery J. Thorac. Cardiovasc. Surg., April 1, 1998; 115(4): 772 - 779. [Abstract] [Full Text] [PDF]

				M. Barbero-Marcial, C. Tanamati, M. B. Jatene, E. Atik, and A. D. Jatene Transxiphoid Approach Without Median Sternotomy for the Repair of Atrial Septal Defects Ann. Thorac. Surg., March 1, 1998; 65(3): 771 - 774. [Abstract] [Full Text] [PDF]

				C. Van Smith, J. P. Jacobs, and R. P. Burke Minimally Invasive Diaphragm Plication in an Infant Ann. Thorac. Surg., March 1, 1998; 65(3): 842 - 844. [Abstract] [Full Text] [PDF]

				H. Reichenspurner, V. Gulielmos, J. Wunderlich, M. Dangel, F. M. Wagner, M. F. Pompili, J. H. Stevens, J. Ludwig, W. G. Daniel, and S. Schuler Port-Access Coronary Artery Bypass Grafting With the Use of Cardiopulmonary Bypass and Cardioplegic Arrest Ann. Thorac. Surg., February 1, 1998; 65(2): 413 - 419. [Abstract] [Full Text] [PDF]

				P. J. Lin, C.-H. Chang, J.-J. Chu, H.-P. Liu, F.-C. Tsai, W.-J. Su, M.-W. Yang, and P. P. C. Tan Minimally Invasive Cardiac Surgical Techniques in the Closure of Ventricular Septal Defect: An Alternative Approach Ann. Thorac. Surg., January 1, 1998; 65(1): 165 - 169. [Abstract] [Full Text] [PDF]

				W. R. Chitwood Jr., C. L. Wixon, J. R. Elbeery, J. F. Moran, W. H. H. Chapman, and R. M. Lust VIDEO-ASSISTED MINIMALLY INVASIVE MITRAL VALVE SURGERY J. Thorac. Cardiovasc. Surg., November 1, 1997; 114(5): 773 - 782. [Abstract] [Full Text]

				P. J. Lin, C.-H. Chang, J.-J. Chu, H.-P. Liu, F.-C. Tsai, F.-C. Lin, C.-W. Chiang, M.-W. Yang, and P. P. C. Tan Video-Assisted Coronary Artery Bypass Grafting During Hypothermic Fibrillatory Arrest Ann. Thorac. Surg., April 1, 1997; 63(4): 1113 - 1117. [Abstract] [Full Text]

				H. Reichenspurner, V. Gulielmos, W. G. Daniel, and S. Schuler Minimally Invasive Coronary-Artery Bypass Surgery N. Engl. J. Med., January 2, 1997; 336(1): 67 - 68. [Full Text]

				J.-J. Chu, C.-H. Chang, P. J. Lin, H.-P. Liu, F.-C. Tsai, D. Wu, C.-W. Chiang, F.-C. Lin, and P. P.C. Tan Video-Assisted Thoracoscopic Operation for Interruption of Patent Ductus Arteriosus in Adults Ann. Thorac. Surg., January 1, 1997; 63(1): 175 - 179. [Abstract] [Full Text]

				S. K Gandhi and K. S. Naunheim The Current Status of Thoracoscopic Surgery Surgical Innovation, December 1, 1996; 3(4): 211 - 223. [Abstract] [PDF]

				C.-H. Chang, P. J. Lin, J.-J. Chu, H.-P. Liu, F.-C. Tsai, F.-C. Lin, C.-W. Chiang, W.-J. Su, M.-W. Yang, and P. P. C. Tan Video-Assisted Cardiac Surgery in Closure of Atrial Septal Defect Ann. Thorac. Surg., September 1, 1996; 62(3): 697 - 701. [Abstract] [Full Text]

				P. J. Lin, C.-H. Chang, J.-J. Chu, H.-P. Liu, F.-C. Tsai, P.-H. Chu, C.-W. Chiang, M.-W. Yang, M.-H. Shyr, and P. P. C. Tan Video-Assisted Mitral Valve Operations Ann. Thorac. Surg., June 1, 1996; 61(6): 1781 - 1786. [Abstract] [Full Text]