SURGICAL CLOSURE OF ATRIAL SEPTAL-DEFECT - MINIMALLY INVASIVE CARDIAC-SURGERY OR MEDIAN STERNOTOMY

Background: Closure of ostium secundum atrial septal de feet (ASD) vis median sternotomy (MS) is a simple procedure for most cardiac surgeon s. Minimally invasive cardiac surgery (MICS) has recently been applied in the management of intracardiac lesions. Methods: We report our exp erience in surgical closure of isolated ASD via MICS in 60 patients an d via MS in 58 patients. There was no difference between these two gro ups in gender, age, body weight, ratio of systemic to pulmonary blood flow, and pulmonary arterial pressure. Results: The duration of cardio pulmonary bypass was significantly longer in the MICS group than in th e MS group [27 to 126 min (42 +/- 12) and 14 to 158 min (27 +/- 11), r espectively; (p < 0.001]. However, the length of incision, incidence o f temporary pacemaker wire insertion rate, duration of endotracheal in tubation, timing of oral intake, postoperative day drainage amount, in cidence of parenteral analgesic injection, postoperative length of sta y, and return to normal activity interval were significant shorter and lower in patients of the MICS group than in those of the MS group. Al l the patients recovered rapidly from the surgery. Follow-up was compl ete in all patients, with no late complications and no residual shunt. Conclusion: Our results suggest that MICS is a good option for surgic al closure of ASD.