Minimally Invasive Atrial Septal Defect Closure: A Single Center Experience

Year 2022, Volume: 32 Issue: 6, 756 - 760, 31.12.2022

Mehmet Çelik Asım Çağrı Günaydın Mehmet Özülkü

https://doi.org/10.54005/geneltip.1178921

Abstract

Minimally Invasive Atrial Septal Defect Closure: A Single Center Experience
Summary and Abstract
Objective:In this study, we wanted to share the results of minimally invasive atrial septal defect closure in our clinic.
Materials and methods: Thirty-six patients who underwent minimally invasive atrial septal defect closure in our clinic between September 2016 and September 2022 were included in the study. Patients who underwent atrial septal defect closure accompanying another cardiac anomaly were excluded from the study. Redo cases in which the sternum was opened before were excluded from the study. Demographic data, physical examination findings, transthoracic echocardiographic and angiographic examination data of the patients were obtained retrospectively from the database of our hospital. Patients with genetic anomalies were noted. This study was approved by the Medical and Health Sciences Research Board of our institution (Project no:KA22/400).
Results: Thirty-six patients (male:11(31%), female:25(69%)) were included in the study. The median age of the patients was 57 months (IQR: 43-83 months) and the median body weight was 16 kg (IQR: 12.7-21.7 kg). Chromosomal anomaly was detected in two (5.5%) patients. A secundum atrial septal defect was detected in 31 (86%) patients, high venosum atrial septal defect in four (11%), and low venosum atrial septal defect in one (3%). Partial sternotomy was performed in 20 patients (56%), and total sternotomy was performed in 16 (44%). The median cardiopulmonary bypass time of the patients was 46.5 minutes (IQR: 36.8-57.2 minutes), and the median X-clamp times were 21.5 minutes (IQR: 15-28.7 minutes). Nine (25%) patients' defects were closed with a patch, and 27 (75%) patients' defects were closed primarily. No mortality was observed in any patient. The median hospital stay was 5 days (IQR: 4-5 days).
Discussion: In our study, no mortality or morbidity was found in cases of atrial septal defect closure performed with minimally invasive method. Minimally invasive atrial septal defect closure can be performed with similar safety and better cosmetic results compared to the standard method.

Keywords

Atrial Septal Defect, Minimally Invasive Cardiac Surgery, Congenital Heart Disease

Project Number

KA22/400

Minimal İnvaziv Atriyal Septal Defekt Kapatılması: Tek Merkez Deneyimi

Abstract

Minimal İnvaziv Atriyal Septal Defekt Kapatılması: Tek Merkez Deneyimi
Özet
Amaç: Bu çalışmada, kliniğimizde minimal invaziv atriyal septal defekt kapatılması yapılan hastaların sonuçlarını paylaşmak istedik.

Gereç ve Yöntemler: Kliniğimizde Eylül 2016 - Eylül 2022 tarihleri arasında minimal invaziv yöntemle atriyal septal defekt kapatılması yapılan 36 hasta çalışmaya alındı. Başka bir kardiyak anomaliye eşlik eden atriyal septal defekt kapatılması yapılan hastalar çalışma dışı bırakıldı. Sternumun daha önce açıldığı redo vakalar çalışma dışı bırakıldı. Hastaların demografik verileri, fizik muayene bulguları, transtorasik ekokardiyografik ve anjiyografik incelemelerine ait veriler hastanemiz veri tabanından retrospektif olarak elde edildi. Genetik anomalisi olan hastalar not edildi. Bu çalışma bağlı bulunduğumuz kurumun Tıp ve Sağlık Bilimleri Araştırma Kurulu tarafından onaylanmıştır(proje no: KA22/400).
Bulgular: Çalışmaya 36 hasta (erkek:11(%31), kız:25(%69)) dâhil edildi. Hastaların yaşları medyan 57 ay (IQR: 43-83 ay) ve vücut ağırlıkları medyan 16 kg (IQR: 12,7-21,7 kg) olarak saptandı. İki (%5,5) hastada kromozom anomalisi saptandı. Otuz bir (%86) hastada sekundum atriyal septal defekt, dört (%11) hastada high venosum atrial septal defekt ve bir (%3) hastada low venosum atriyal septal defekt saptandı. Yirmi hastada (%56) parsiyel sternotomi, 16 (%44) hastada total sternotomi yapıldı. Hastaların kardiyopulmoner by-pass süreleri medyan 46,5 dakika (IQR: 36,8-57,2 dakika) ve X klemp süreleri medyan 21,5 dakika (IQR: 15-28,7 dakika) olarak saptandı. Dokuz (%25) hastanın defekti yama ile, 27 (%75) hastanın defekti ise pirimer kapatıldı. Hiçbir hastada mortalite izlenmedi. Hastanede kalış süresi medyan 5 gün (IQR: 4-5 gün) olarak saptandı.
Sonuç: Çalışmamızda minimal invaziv yöntemle yapılan atriyal septal defekt kapatılması olgularında mortalite ve morbiditeye rastlanmamıştır. Minimal invaziv atriyal septal defekt kapatılması standart yönteme oranla benzer güvenlikle ve daha iyi kozmetik sonuçlarla yapılabilir.

Keywords

Atriyal Septal Defekt, Minimal İnvaziv Kalp Cerrahisi, Konjenital Kalp Hastalığı

Project Number

KA22/400

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