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Ann Thorac Surg 2006;81:1417-1419
© 2006 The Society of Thoracic Surgeons

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Original article: Cardiovascular

New Minimally Invasive Technique to Occlude Secundum Atrial Septal Defect in 53 Patients

^a Cardiac Surgical Department, Wuhan Asia Heart Hospital, WuHan, China
^b Ultrasonic Department, Wuhan Asia Heart Hospital, WuHan, China
^c Cardiac Surgical Department, Singapore National Heart Center, Singapore

Accepted for publication September 30, 2005.

^_* Address correspondence to Dr XiangJun, Tao Liang Cardiac Surgical Department, Wuhan Asia Heart Hospital, WuHan 430022, China (Email: zengxiangjun{at}sohu.com).

BACKGROUND: Conventional surgical atrial septal defect (ASD) closure requires cardiopulmonary bypass, whereas percutaneous transcatheter closure is limited by maximal defect size of 34 mm and access to the neck. We describe a new minimally invasive approach using a right minithoracotomy to deploy an occluder without cardiopulmonary bypass.

METHODS: Between October 2004 and April 2005, 53 secundum ASDs were closed by this method. Through a 3-cm incision in the right fourth intercostal space, a minithoracotomy exposes the right atrium to facilitate deployment of the septal closure device. The age of the patients was from 2 to 61 years. The ASD size was 12 to 39 mm.

RESULTS: All ASDs were successfully closed with a mean device size of 33.1 ± 8 mm (range, 16 to 46 mm). The procedure duration was 30 to 60 minutes. All patients were extubated on table, with less than a 1-day stay in the intensive care unit. The hospital stay was 3 to 7 days. There was no postoperative mortality. At mean follow-up of 1 to 8 months, there were no major morbidities. One patient had minimal residual shunt that resolved 1 month later.

CONCLUSIONS: This new minimally invasive method of secundum ASD closure is safe and cosmetically superior to conventional surgery. Early results are encouraging.

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