I vantaggi della correzione mininvasiva delle cardiopatie congenite riletti dopo 25 anni di esperienza

Abstract

Background - For many years the treatment of congenital heart disease has been performed through median sternotomy. Recently, the dimensions of the cutaneous incision have been reduced to optimize functional recovery and improve the aesthetic result. However, there are still few experiences in this field. Objectives - The objective of the study is to describe the results of minimally invasive cardiac surgery at the Paediatric Cardiac Surgery Unit of the Hospital-University of Padua in over 25 years of experience. Materials and Methods - The study included all paediatric patients who underwent minimally invasive cardiac surgery (ministernotomy, right anterior minithoracotomy, or right lateral minithoracotomy) between January 1998 and December 2022. Intraoperative and early postoperative (during hospitalization) outcomes were investigated. Results - All patients (1,111) underwent a successful correction, without any need for conversion to median sternotomy. The median length of stay in the intensive care unit was 1 day (1-2 days), and in the hospital was 5 days (4-6 days). There were no in-hospital deaths and the rate of major complication was 3% (33/1,111 patients). Conclusions - The treatment of congenital heart disease with minimally invasive cardiac surgery when performed in experienced centres shows excellent clinical results without any additional risk compared to the traditional median sternotomy. For this reason, minimally invasive cardiac surgery has been the gold standard for the treatment of many congenital heart diseases for over 25 years.