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  • Title: New minimally invasive technique to occlude secundum atrial septal defect in 53 patients.
    Author: Liang T, XiangJun Z, XiaoJing M, Yun L, Leng CY.
    Journal: Ann Thorac Surg; 2006 Apr; 81(4):1417-9. PubMed ID: 16564284.
    Abstract:
    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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