Transxiphoid Approach Without Median Sternotomy for the Repair of Atrial Septal Defects

• Published in: The Annals of thoracic surgery Vol. 65; no. 3; pp. 771 - 774
• Main Authors: Barbero-Marcial, Miguel, Tanamati, Carla, Jatene, Marcelo B, Atik, Edmar, Jatene, Adib D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-03-1998; Elsevier Science
• Subjects: Adolescent; Biological and medical sciences; Child; Child, Preschool; Extracorporeal Circulation - methods; Female; Heart Septal Defects, Atrial - surgery; Humans; Infant; Male; Medical sciences; Minimally Invasive Surgical Procedures - methods; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Tropical medicine; Xiphoid Bone; Human; Corrective surgery; Prognosis; Persistent fetal circulation; Treatment efficiency; Video technique; Cardiovascular disease; Congenital disease; Guidance; Treatment; Heart disease; Surgery; Surgical approach; Endoscopy; Technique; Child; Ostium secundum; Thoracoscopy
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/S0003-4975(97)01433-1

Background. Interest in minimally invasive procedures has recently increased because it results in less surgical trauma, decreased patient discomfort, short hospital stay, reduced costs, and better cosmetic appearance. Based on these facts, we have been using the transxiphoid process approach without sternotomy for the correction of atrial septal defects.
Methods. From July 1996 to January 1997, the xiphoid process window approach was performed in 10 patients with ostium secundum atrial septal defect. Ages ranged from 6 months to 14 years (mean, 5.3 years). In all patients, extracorporeal circulation was carried out by means of cannulation of the femoral artery and both caval veins and of aortic cross-clamping. Videothoracoscopy was used to improve visualization of the aorta.
Results. There were no intraoperative or postoperative complications, and in all but 1 patient, extubation was possible while in the operating room.
Conclusions. The xiphoid process window, with no median sternotomy, permitted closure of the atrial septal defects with good results and could be used as a less invasive technique for their correction.