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

This Article Full Text Full Text (PDF) 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 Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Koray Ak Tayfun Aybek Gerhard Wimmer-Greinecker Farhad Bakhtiary Anton Moritz Selami Dogan Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ak, K. Articles by Dogan, S. Search for Related Content PubMed Articles by Ak, K. Articles by Dogan, S. Related Collections Congenital - acyanotic Congestive Heart Failure

J Thorac Cardiovasc Surg 2007;134:757-764
© 2007 The American Association for Thoracic Surgery

Surgery for Congenital Heart Disease

Evolution of surgical techniques for atrial septal defect repair in adults: A 10-year single-institution experience

Department for Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University, Frankfurt/Main, Germany.

Received for publication February 18, 2007; revisions received March 29, 2007; accepted for publication April 9, 2007.

^_* Address for reprints: Koray Ak, MD. (Email: akkoray{at}hotmail.com).

Objective: We retrospectively analyzed our experience in atrial septal defect repair with varied minimally invasive surgical approaches.

Methods: From 1997 to 2006, 64 patients underwent surgical repair of atrial septal defects in our center. Patients were grouped into four groups according to the approach used; group 1 (n = 16), partial lower sternotomy; group 2 (n = 20), right anterior small thoracotomy with transthoracic clamping; group 3 (n = 4), right anterior small thoracotomy with endoaortic balloon clamping; and group 4 (n = 24), totally endoscopic approach with the use of the da Vinci surgical system (Intuitive Surgical, Mountain View, Calif). Preoperative diagnosis was a large secundum type atrial septal defect in 60 patients, primum type in 3 patients, and sinus venosus type in 1 patient.

Results: Complete atrial septal defect closure was verified by intraoperative transesophageal echocardiography in all patients. There was neither perioperative mortality nor major complication. Groups 3 and 4 had significantly longer aortic crossclamp, cardiopulmonary bypass, and skin-to-skin operative times than had groups 1 and 2 (P = .000). All groups had similar ventilation time, postoperative drainage, and intensive care unit and hospital stays. Only 2 patients in group 4 were converted to the minithoracotomy owing to endoaortic balloon failure. During the follow-up of 30 ± 24.3 months, 1 patient in group 3 was reoperated on owing to significant residual shunting.

Conclusions: All types of atrial septal defects can be repaired via those four different approaches as safely as can be done by the conventional technique. General complications during surgical procedures are negligible. These approaches may be considered a standard treatment and an adjunct to transcatheter treatment options in atrial septal defect repair.

This article has been cited by other articles:

				K. Ak and Y. Besir What is the Ideal Patch Material for ASD Closure? Ann. Thorac. Surg., August 1, 2008; 86(2): 692 - 693. [Full Text] [PDF]