The correction of congenital heart defects with less invasive approaches

Background: The minimally and less invasive approaches for the surgical tre atment of different heart diseases are rapidly increasing because of their cosmetic and recovery-related advantages. Presented here are the results of less invasive surgery in 51 patients with congenital heart defects. Method s: From lune 1996 to January 1999, we used less invasive techniques for the correction of congenital heart defects in 51 patients. In 32 patients, we performed right anterolateral thoracotomy (6-13 cm), and on the other 19 pa tients, we used the partial inferior sternotomy (4-7 cm). The ascending aor ta and the caval veins were cannulated in all patients. Results: The follow ing congenital heart defects were corrected: ostium secundum atrial septal defect (n=35), sinus venosus atrial septal defect with partial anomalous pu lmonary venous connection (n=7), ventricular septal defect (n=7), tetralogy of Fallot (n=1), and cor triatriatum sinistrum (n=1). The average age of t he patients was 15 years old ranging from 2 months to 48 years and the aver age weight 39.6 kg (range 3.8-86 kg). The patients were removed from artifi cial respiratory support on average 8 hours (range 1-48 hours) after surger y and left the hospital after 7 days (range 2-10 days). In 16 patients, blo od transfusions were required, an average 5.7 ml/kg BW (range 1.45-19.75 ml /kg BW). The postoperative course was uneventful in all patients. Follow-up (range 3-33 months, mean 17.5 months) was complete with no late deaths or residual defects. Conclusion: The right anterolateral thoracotomy and the p artial inferior sternotomy provide a safe approach for the correction of ce rtain congenital heart defects. These techniques enable operative correctio n without any additional risks being incurred and can be performed with sta ndard instruments and cannulation. Additional approaches for extracorporeal circulation are unnecessary.