Atrial Septal Defect Closure by Anterior Mini Thoracotomy with Total Peripheral Cannulation: A Step towards Establishing Mini Invasive Cardiac Surgery in a Developing Nation
Background:Atrial Septal Defect
(ASD) closure is a common cardiac surgical procedure performed worldwide. Due
to favourable clinical outcome, minimal invasive approach is becoming popular.
Hence this study was conducted to compare the outcome of two surgical
approaches, median sternotomy and mini thoracotomy with total peripheral
cannulation, in a developing country Nepal. Methods: A prospective study
of 62 ASD patients, randomized to undergo surgical closure either via right
anterior mini thoracotomy or median sternotomy was conducted and followed up
over three years. The clinical outcome parameters like intensive care unit
stay, hospital stay, post-operative duration of ventilation, cardiopulmonary
bypass time, aortic cross clamp time, mediastinal drainage, size of scar and
complication were compared between two groups. Results: Cardiopulmonary
bypass time and aortic cross clamp time were significantly longer in right
anterior mini thoracotomy group as compared to median sternotomy group (43.97min ± 12.70min vs 34.42min ± 10.42min and 25.13min ±7.82min vs 19.48min ± 6.93min respectively, p-value<0.05). There was no significant difference in duration of surgery
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