2008. KTCS meeting

Robotic ASD repair with rigid Robotic ASD repair with rigid port port

Hyung Gon Je, Jae Won Lee, Sung Ho JungHyung Gon Je, Jae Won Lee, Sung Ho Jung

Suk Jung Choo, Hyun Song, Cheol Hyun ChungSuk Jung Choo, Hyun Song, Cheol Hyun Chung

Asan Medical Center, Ulsan University, School of Medicine

Totally endoscopic ASD repair

Totally endoscopic ?

Case: F/24

Sx; resting chest pain, DOE Fc I

Echo;

Normal LV, NSR, no MR, TR +1

Secundum ASD 22 mm size with thin aortic rim, L->R shunt

Device closure was planned but nickel allergy -> op.

da Vinci ASD patch closure with rigid port assist

ASD patch closure with Gore-Tex 0.5mm patch

ACC with Chitwood clamp

Antegrade cardioplegic infusion via root cannula

Port positioning

Coordination

Totally Endoscopic ASD repair

Meta-analysis of TE-ASDR

Bonaros N, Bonatti J. - Innsbruck; 5

Argenziano M, Smith CR. – NY, Columbia; 5

Alfieri O. - Milan; 3

Moritz A, Dogan S - Frankfurt; 3

Sporadic case reports; 6

Meta-analysis of TE-ASD repair

Alfieri- Milan

- Heart Surg Forum 2002;5

(2):125

Moritz-Frankfurt

-JTCVS 2007;134:757

Bonatti-Innsbruck

–ATS 2006;82:687

Argenziano-NY

–Circulation 2003;108 sup

plII:191

N (ASD,PFO) 7 (5, 2) 24 (all ASD) 17 (14, 3) 17 (12, 5)

Direct closure 7 20 15 17

Patch closure 0 4 2 0

OP time (min) - 262.6 ± 60.6 314 (215-590) -

CPB time (min) 101.8 ± 39.6 135.2 ± 39.2 144 (91-239) 122

ACC time (min) 63.4 ± 21.9 63.6 ± 20.4 69 (41-133) 32

Vent (hr) Less than 7hr - 7hr (2-19) Night of surgery

ICU stay (hr) 23.4 ± 8 26 (15-120) 20

Hosp stay (d) 7.9 ± 1.9 8 (5-14) 4 (2.5-10)

Comment Normal life < 1wk ASD; 24.6±10

mm

Results

Op / CPB / ACC time; 320 / 228 / 109 min

Ventilation; 5hr, ICU stay ; 22hr

Hospital stay; 3 day

Post op Echo; no residual shunt

Return to work place within 1wks; CPA

Summary