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  • Title: Totally endoscopic computer-enhanced atrial septal defect closure in six patients.
    Author: Torracca L, Ismeno G, Alfieri O.
    Journal: Ann Thorac Surg; 2001 Oct; 72(4):1354-7. PubMed ID: 11603460.
    Abstract:
    BACKGROUND: Totally endoscopic procedures have been introduced into cardiac surgery with the application of telemanipulating robotic systems. We report 6 cases of closed-chest atrial septal defect (ASD) closure using a robotic device. METHODS: After deflating the right lung, the endoscopic camera and two robotic arms were inserted into the right hemithorax through 8-mm ports. An accessory port was placed for blood suction and for introduction of ancillary endoscopic instruments. After femoral-femoral cannulation for cardiopulmonary bypass (CPB), aortic occlusion, and cardioplegia delivery, the intracardiac correction was carried out in 5 patients with an ostium secundum ASD and in 1 patient with a patent foramen ovale (PFO) and atrial septal aneurysm (ASA). The ASDs were closed with a continuous braided polyester suture. The PFO closure with septal aneurysm plication was carried out with interrupted stiches. RESULTS: Mean CPB and cross-clamp times were 106 +/- 22 and 67 +/- 13 minutes, respectively. Extubation was carried out within the seventh postoperative hour. All patients returned to normal function within the first postoperative week. CONCLUSIONS: Totally endoscopic ASD closure can be carried out safely using robotic techniques with rapid postoperative recovery and an excellent cosmetic result.
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