Comparison of two surgical approaches for the treatment of atrial septal defects

Ahmed Farouk; Nashwa Abd Elhafez; Gamal Nassar; Ahmed Mandour; Mohamed Osman; Mohamed Abd Elhafez

Ahmed Farouk Department of Cardiothoracic Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt
Nashwa Abd Elhafez Department of Anesthesia and Intensive care, Faculty of Medicine, Assiut University, Assiut, Egypt
Gamal Nassar Molecular Geneticist, Metabolic and Genetic disorders unit, Faculty of Medicine, Assiut University, Assiut, Egypt
Ahmed Mandour Department of Anesthesia and Intensive care, Faculty of Medicine, Assiut University, Assiut, Egypt
Mohamed Osman Department of Cardiology, Faculty of Medicine, Assiut University, Assiut, Egypt
Mohamed Abd Elhafez Department of Cardiothoracic Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt.

Keywords: Atrial septal defect, Minimally invasive cardiac surgery, Median sternotomy

Abstract

Background: Cardiac surgery has adopted less invasive procedures in the last two decades, aiming to reduce surgical insult and achieve early patient recovery. The present study compared median sternotomy and minimally invasive techniques for managing atrial septal defects.

Methods: The current study is a prospective cohort comparative study that included 67 patients randomly divided into two groups. Group A included 34 patients with median sternotomy; their ages ranged from 2 to 40 years (mean± SD 36.12±7.3 years). Group B (n= 33) underwent minimally invasive surgery, and their ages ranged from 21 to 46 years (mean± SD 32.09±7.35).

Results: Minimally invasive patients had fewer blood transfusions (1.06±0.24 vs. 1.79±0.25 units, P<0.001), less pain on the second day (3.73±0.72 vs. 7.94±1.01, P<0.001) and fifth day (2.09±0.52 vs. 5.38±.49, P<0.001) of the operation, and a shorter duration of hospital stay (4.85±0.75 vs. 6.38±0.78 days, P<0.001) than median sternotomy patients. Wound infection was reported in three cases with minimally invasive surgery, while nine patients had wound infection with median sternotomy. However, both groups had no reported mortality after two months of follow-up.

Conclusion: Atrial septal defect closure with minimally invasive approaches could be safe with low morbidity, a fast recovery phase, and the ability to restore normal activities.