Minimally invasive repair of fenestrated atrial septal aneurysm

J Vis Surg. 2016 Jan 27:2:21. doi: 10.3978/j.issn.2221-2965.2015.12.05. eCollection 2016.

Abstract

Background: Atrial septal aneurysms (ASAs) are uncommon but are associated with significant embolic morbidity when an interatrial communication is present. Although surgical reconstruction has traditionally been approached through a median sternotomy, minimally invasive techniques may be employed to reduce pain and recovery time.

Methods: We present a video-assisted technique via right inframammary minithoracotomy utilizing peripheral cannulation for cardiopulmonary bypass. Included is a discussion of surgical tips, potential pitfalls and a description of unique technical aspects that differentiate atrial septal repair from other minimally invasive cardiac operations.

Results: A complete repair of the defect was confirmed by intraoperative transesophageal echocardiography (TEE). The patient made an uncomplicated recovery and was discharged home within 48 hours of surgery.

Conclusions: Minimally invasive repair of an ASA utilizing peripheral cannulation for cardiopulmonary bypass and a right inframammary incision can be accomplished with satisfactory technical success and recovery time.

Keywords: Atrial septal aneurysm (ASA); atrial septal defect; minimally invasive cardiac surgery; peripheral cannulation; transesophageal echocardiography (TEE).