Port Access (TM) surgery for congenital heart disease

Objectives: Minimally invasive surgical techniques have been introduced int o cardiac surgery in order to avoid median sternotomy related complications . Surgical trauma to the patient can be significantly reduced without compr omising the safety. Ln addition, a small lateral chest incision results in improved cosmesis, especially in female patients. Methods: Thirteen patient s (median age 39 +/- 14 years, ranged from 17-61 years) with atrial septal defect were treated with a minimally invasive surgical method using a modif ied Port Access(TM) technique. In all patients access to the heart was achi eved via a small (4-8 cm) right lateral chest incision in the 4th intercost al space. In these patients the selection of the Port Access(TM) system was used for cardiopulmonary bypass via the femoral vessel and for the applica tion of cardioplegic solution. Results: No deaths or intraoperative complic ations were observed in any of the patients. The postoperative course was u neventful and only minor complications were observed postoperatively. The m edian hospital stay was 8.0 +/- I days (median +/- SEM). Conclusion: This m inimally invasive surgical technique for the treatment of atrial septal def ects represent a safe alternative to conventional treatment of ASD using me dian sternotomy and standard cardiopulmonary bypass. The exposure of the ri ght atrium via the 4th intercostal space is ideal and can be performed with excellent cosmetic results. (C) 1999 Elsevier Science B.V. All rights rese rved.