Objectives: Minimally invasive cardiac surgery has recently become widespread. The aim of this study is to analyse the feasibility of a minimally invasive approach for coronary artery fistula (CAF) correction. Methods: From February 2001 to June 2014, 49 patients in our centre underwent minimally invasive CAF correction without cardiopulmonary bypass (CPB). The mean age was 21.18 ± 11.24 years (range, 5 months to 64 years). Patients with cardiac anomalies who underwent CAF correction and those who underwent CAF via the minimally invasive approach with CPB were excluded. Results: There were no in-hospital mortalities or conversions to median sternotomy. Subxiphoid incisions (22 cases) and parasternal incisions (20 cases) were the most commonly used approaches for the procedure. The operative time was 67.45 ± 22.69 min (30-125 min). The intubation time was 3.72 ± 1.82 h (2-12 h), and the ICU stay was 9.67 ± 5.43 h (4-24 h). A trivial residual shunt was identified in only 1 patient during the procedure; however, this shunt had disappeared by discharge. Conclusions: The minimally invasive approach can provide excellent surgical exposure for CAF ligation in select patients. This approach is a safe and cosmetic alternative to conventional treatment and may minimize the length of stay.
Objectives: Minimally invasive cardiac surgery has recently become widespread. The aim of this study is to analyse the feasibility of a minimally invasive approach for coronary artery fistula (CAF) correction. Methods: From February 2001 to June 2014, 49 patients in our centre underwent minimally invasive CAF correction without cardiopulmonary bypass (CPB). The mean age was 21.18 ± 11.24 years (range, 5 months to 64 years). Patients with cardiac anomalies who underwent CAF correction and those who underwent CAF via the minimally invasive approach with CPB were excluded. Results: There were no in-hospital mortalities or conversions to median sternotomy. Subxiphoid incisions (22 cases) and parasternal incisions (20 cases) were the most commonly used approaches for the procedure. The operative time was 67.45 ± 22.69 min (30-125 min). The intubation time was 3.72 ± 1.82 h (2-12 h), and the ICU stay was 9.67 ± 5.43 h (4-24 h). A trivial residual shunt was identified in only 1 patient during the procedure; however, this shunt had disappeared by discharge. Conclusions: The minimally invasive approach can provide excellent surgical exposure for CAF ligation in select patients. This approach is a safe and cosmetic alternative to conventional treatment and may minimize the length of stay.