Totally Thoracoscopic Repair Of Atrial Septal Defect A Report Of 52 Cases

Objective:To summarize the experience of ASD repair under total thoracoscopic.Methods:52 cases of ASD repair total thoracoscopic extracorporeal circulation were analyzed retrospectively.Cardiopulmonary bypass(CPB)was established by right femoral arteriovenous intubation.Three holes were made on the right chest wall to perform the operation of ASD repair in total thoracoscopy.Results:In this study,a total of 52 cases of atrial septal defect repair were completed,without perioperative death.The operation time was 161-440 min,with an average(269.82 ±51.47)min,and the cardiopulmonary bypass time was50-230 min,with an average 139.38± 36.32)min.The crossclamp time of ascending aorta was 36-198 min,with an average(79.49± 29.09))min.The time of postoperative ventilator-assisted time was 7.5-37 h,with an average(15.20± 6.14)h;Postoperative intensive care time was 12-77.5 h,with an average(39.8±14.9)h,and the patient was discharged 5-15 days after surgery,with an average(7.8±2.2)d.9 cases underwent tricuspid annuloplasty at the same time.2 cases underwent defibrillating after the ascending aortic crossclamp were off.1 case underwent thoracotomy because of bleeding after operation,which was caused by thymus tissue injury.One case of femoral artery rupture was repaired during the operation and result is good.Echocardiography was performed in all patients before discharge in all patients.no residual shunt was found.The patients were followed up for 1-22 months after the operation,and there were no residual shunt,no hematoma at the femoral arteriovenous area,no abnormal sensory movement of legs,no cerebral embolism,no fluid pneumothorax,no atelectasis,there was 1 case of wound infection.Conclusion:The totally thoracoscopic(TTS)repair of atrial septal defect in selected cases is a safe and feasible procedure with less trauma and quick recovery.