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A single center experience with minimally invasive approaches in congenital cardiac surgery.

Publication ,  Journal Article
Nellis, JR; Daneshmand, MA; Gaca, JG; Andersen, ND; Haney, JC; Turek, JW
Published in: J Thorac Dis
October 2021

BACKGROUND: Cardiac surgery is a technically demanding field with an appreciable learning curve that extends beyond formal training. Minimally invasive congenital cardiac surgery has one of the steepest learning curves. Early complications often discourage surgeons, particularly those at lower volume centers, from pursuing innovative approaches. Over the past three years, we have utilized a number of minimally invasive approaches including pulmonary valve replacement, anomalous aortic origin coronary artery repair, atrial septal defect repair, epicardial lead placement, and partial anomalous pulmonary venous return. Herein we report on our experience performing minimally invasive congenital cardiac surgery, lessons learned, and how our approach has evolved. METHODS: We performed a single institution, retrospective review, wherein continuous variables were reported as median (interquartile range). RESULTS: Between September 2017 and May 2020, minimally invasive approaches were attempted on 49 patients with a median age of 19 years (14-47 years) for nine distinct congenital cardiac diagnoses. Seven patients (14%) required conversion to larger incisions, including four patients or 36% of those undergoing anomalous aortic origin of a coronary artery repair. Patients who were converted had a higher body mass index 33.1 (31.7-37.8) than those who were not (24.2, 20.8-29.3) (P=0.009). CONCLUSIONS: Minimally invasive approaches for congenital cardiac conditions require a team approach. Patients with a body mass index greater than 30 should be counseled on the higher rate of conversion. We no longer perform minimally invasive anomalous aortic origin of a coronary artery repair given the high rate of conversions and complications. Surgeons attempting this procedure should do so cautiously.

Duke Scholars

Published In

J Thorac Dis

DOI

ISSN

2072-1439

Publication Date

October 2021

Volume

13

Issue

10

Start / End Page

5818 / 5825

Location

China

Related Subject Headings

  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
  • 1103 Clinical Sciences
 

Citation

APA
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ICMJE
MLA
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Nellis, J. R., Daneshmand, M. A., Gaca, J. G., Andersen, N. D., Haney, J. C., & Turek, J. W. (2021). A single center experience with minimally invasive approaches in congenital cardiac surgery. J Thorac Dis, 13(10), 5818–5825. https://doi.org/10.21037/jtd-21-836
Nellis, Joseph R., Mani A. Daneshmand, Jeffrey G. Gaca, Nicholas D. Andersen, John C. Haney, and Joseph W. Turek. “A single center experience with minimally invasive approaches in congenital cardiac surgery.J Thorac Dis 13, no. 10 (October 2021): 5818–25. https://doi.org/10.21037/jtd-21-836.
Nellis JR, Daneshmand MA, Gaca JG, Andersen ND, Haney JC, Turek JW. A single center experience with minimally invasive approaches in congenital cardiac surgery. J Thorac Dis. 2021 Oct;13(10):5818–25.
Nellis, Joseph R., et al. “A single center experience with minimally invasive approaches in congenital cardiac surgery.J Thorac Dis, vol. 13, no. 10, Oct. 2021, pp. 5818–25. Pubmed, doi:10.21037/jtd-21-836.
Nellis JR, Daneshmand MA, Gaca JG, Andersen ND, Haney JC, Turek JW. A single center experience with minimally invasive approaches in congenital cardiac surgery. J Thorac Dis. 2021 Oct;13(10):5818–5825.

Published In

J Thorac Dis

DOI

ISSN

2072-1439

Publication Date

October 2021

Volume

13

Issue

10

Start / End Page

5818 / 5825

Location

China

Related Subject Headings

  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
  • 1103 Clinical Sciences