Video-Assisted Cardiac Surgery in Closure of Atrial Septal Defect

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Video-Assisted Cardiac Surgery in Closure of Atrial Septal Defect Chang Chau-Hsiung, MD, Pyng Jing Lin, MD, Jaw-Ji Chu, MD, Hui-Ping Liu, MD, Feng-Chun Tsai, MD, Fun-Chung Lin, MD, Cheng-Wen Chiang, MD, Wen-Jen Su, MD, Min-Wen Yang, MD, Peter P.C. Tan, MD The Annals of Thoracic Surgery Volume 62, Issue 3, Pages 697-701 (August 1996) DOI: 10.1016/S0003-4975(96)00461-4 Copyright © 1996 The Society of Thoracic Surgeons Terms and Conditions

Fig. 1 Transesophageal echocardiograms obtained in patient 1. (A) Preoperative echocardiogram revealed an atrial septal defect of the ostium secundum, fossa ovalis type. (B) Preoperative echocardiogram revealed left-to-right shunt. (C) Postoperative echocardiogram showed complete closure of the defect. (D) Postoperative echocardiogram showed no residual shunt. The Annals of Thoracic Surgery 1996 62, 697-701DOI: (10.1016/S0003-4975(96)00461-4) Copyright © 1996 The Society of Thoracic Surgeons Terms and Conditions

Fig. 2 Incision sites. Arrowhead indicates thoracotomy created in the seventh intercostal space in the posterior axillary line for introduction of the endoscope and insertion of pleural tube. Arrow indicates manipulation incision (7cm) created in the fourth intercostal space in the midclavicular line. Double arrowheads indicate thoracotomies created in the seventh intercostal space in the anterior axillary line for insertion of the pericardial tube. The Annals of Thoracic Surgery 1996 62, 697-701DOI: (10.1016/S0003-4975(96)00461-4) Copyright © 1996 The Society of Thoracic Surgeons Terms and Conditions

Fig. 3 Pictures of closure of the atrial septal defect taken by video-assisted endoscope. (A) After pericardiotomy, the right atrium was easily approached by the endoscope. (B) The defect was closed primarily with a running suture. Care was taken to fill the left atrium with blood. (C) A 32F chest tube was inserted into the superior vena cava via a right atriotomy and connected to the venous cannula of the extracorporeal circulation for drainage of the venous blood from the superior vena cava. (D) After closure of the atrial septal defect, the right atriotomy was closed with a running suture. The Annals of Thoracic Surgery 1996 62, 697-701DOI: (10.1016/S0003-4975(96)00461-4) Copyright © 1996 The Society of Thoracic Surgeons Terms and Conditions