Objective:
Over the last years many minimally invasive approaches(MIA)have been described to treat different cardiac anomalies in the paediatric population. Simple pathologies can be safely treated with small incision reducing the psychological trauma without an increased surgical risk.
Methods:
During the last 3 years 35 patient were treated with a MIA. A superior J ministernotomy was used in subaortic valvular stenosis in 5 patients(mean age 11,6 yy), an inferior J ministernotomy was used in 18 patients(mean age 5,7 yy)with type secundum ASD and a right antero-lateral minithoracotomy was adopted in 12 patients(mean age 16 yy)with a type secundum ASD.
Results:
There were no death and only one patient with an ASD treated with a ministernotomy required an extension to a full sternotomy for difficulty in the aortic cannulation. No surgical related events were recorded.
Comment:
The psychological impact of the scar in the young patients should not be underestimated. In the last 3 years we treated more than 90% of ASDs with a minimally invasive approach while in the last 2 years all patients presenting with an isolated subvalvular aortic stenosis were treated with a ministernotomy. The use of a wide spectrum of minimally invasive approaches allowed us to tailor the best approach for every single patient according to pathology, age, copathologies and to increase the number of patients that can benefit from MIA. Probably further use of different approaches will allowed us to widen even more the spectrum of pathologies and patients treateble with minimally invasive approach.