Surgical repair of congenital cardiac lesions: Minimally invasive surgical approach – limitation of incision and partial sternotomy even in infants under 15 kilograms (kg)

I. Knez; A. Mircic; D. Dacar; B. Heinzl; A. Gamillscheg; J. Krumnikl; E. Mahla; W. Toller; S. Rödl; G. Zobel; B. Rigler

doi:10.1055/s-2008-1037906

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Thorac Cardiovasc Surg 2008; 56 - P63
DOI: 10.1055/s-2008-1037906

Surgical repair of congenital cardiac lesions: Minimally invasive surgical approach – limitation of incision and partial sternotomy even in infants under 15 kilograms (kg)

I Knez ¹, A Mircic ¹, D Dacar ¹, B Heinzl ², A Gamillscheg ², J Krumnikl ³, E Mahla ³, W Toller ³, S Rödl ⁴, G Zobel ⁴, B Rigler ¹

¹Universitätsklinik für Chirurgie, Klinische Abteilung für Herzchirurgie, Graz, Austria
²Universitätsklinik für Kinderheilkunde, Klinische Abteilung für Kinderkardiologie, Graz, Austria
³Universitätsklinik für Anästhesiologie und Intensivmedizin, Klinische Abteilung für Herz-, Gefäßanästhesie, Graz, Austria
⁴Universitätsklinik für Kinderheilkunde, Kinderintensiv, Graz, Austria

Congress Abstract

Objective: We report on prospective clinical data about a newly modified minimally invasive technique for surgical repair of even complex congenital cardiac lesions with main emphasis on infant patients under 15kg.

Methods: From August 2005 to August 2007, 20 patients underwent this procedure (MMIT-modified minimally invasive technique).The heart is exposed through a limited midline skin incision and partial sternotomy,CPB is established by specially designed flexible highflow aortic and dual venous cannulas (Medtronic). Obtained basic results were matched to those from 20 patients in standard technique (ST).

Results: Morphology was more complex in MMIT pts (Diagnoses:8 pts ASD II (1pt tracheostoma+longtime ventilation), 3 pts ASD II+supravalvular PST, 3 pts defect of sinus venosus (1pt tracheostoma+longtime ventilation), 3 pts complex ASD II + overriding SVC,1 pt ASD II+VSD, 1 pt partial anomaly of pulmonary vein connection, 1 pt cor triatriatum.

Variable	MIPS –12 pts<15kg	ST –10 pts<15kg	Sign. p<0.05
Age/yrs	2.5	3.4	n.s.
OP time/min	149	135	n.s.
X-clamp time/min	20 (7–32)	18 (15–21)	n.s.
Ventilation/hrs	3.6	10.5	p<0.05

Conclusion: MIPS-approach achieves a cosmetically superior result with standard instrumentation and cardiopulmonary bypass techniques, without compromising exposure or using peripheral incisions.