caa a22 4500 388116242 CHVBK 20180307125407.0 cr unu---uuuuu 161130e199911 xx s 000 0 eng 10.1017/S1047951100005606 doi S1047951100005606 pii (NATIONALLICENCE)cambridge-10.1017/S1047951100005606 A 5-year experience with surgical repair of atrial septal defect employing limited exposure [Elektronische Daten] Abstract Background There has been a trend in recent years towards less invasive therapy for many congenital cardiac malformations. For the past 5 years, we have employed a technique of limited surgical exposure when repairing atrial defects within the oval fossa. Methods Over the 5-year period from July 1992 to August 1997, 115 consecutive patients underwent surgical repair of an isolated atrial septal defect in the region of the oval fossa by a single surgeon. The patients had a limited midline skin incision starting at the line of the nipples and extending inferiorly across 2 to 3 intercostal spaces. A partial sternotomy was performed, sparing the manubrium. Standard instruments and cannulation techniques were used for cardiopulmonary bypass and fibrillatory arrest. Results There were no deaths and no major complications. The median time to extubation after leaving the operating room was 3 hours (30 minutes to 8 days). Mediastinal drains were removed the morning after surgery. The median stay in the intensive care unit was 7 hours (3 hours to 10 days), and patients were discharged from the hospital a median of 4 days postopera-tively (2 to 23 days). Conclusions This approach using limited exposure can be applied safely without any new instruments and without peripheral incisions or sites of vascular access, while providing a comfortable exposure for the surgeon and achieving a cosmetically superior result for the patient. Copyright © Cambridge University Press 1999 minimally invasive surgical procedures nationallicence congenital heart defects nationallicence critical pathways nationallicence Khan Junaid H. Division of Cardiothoracic Surgery, University of California, San Francisco, CA, USA McElhinney Doff B. Division of Cardiothoracic Surgery, University of California, San Francisco, CA, USA Reddy V. Mohan Division of Cardiothoracic Surgery, University of California, San Francisco, CA, USA Hanley Frank L. Division of Cardiothoracic Surgery, University of California, San Francisco, CA, USA Cardiology in the Young Cambridge University Press 9/6(1999-11), 572-576 1047-9511 9:6<572 1999 9 CTY https://doi.org/10.1017/S1047951100005606 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1017/S1047951100005606 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Khan Junaid H. Division of Cardiothoracic Surgery, University of California, San Francisco, CA, USA NATIONALLICENCE 700 1- McElhinney Doff B. Division of Cardiothoracic Surgery, University of California, San Francisco, CA, USA NATIONALLICENCE 700 1- Reddy V. Mohan Division of Cardiothoracic Surgery, University of California, San Francisco, CA, USA NATIONALLICENCE 700 1- Hanley Frank L. Division of Cardiothoracic Surgery, University of California, San Francisco, CA, USA NATIONALLICENCE 773 0- Cardiology in the Young Cambridge University Press 9/6(1999-11), 572-576 1047-9511 9:6<572 1999 9 CTY CC0 http://creativecommons.org/publicdomain/zero/1.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-cambridge