Ersin Kadirogullari1, Burak Onan1, Baris Timur1, Ali Birant2, Adem Reyhancan1, Serdar Basgoze1, Unal Aydin1. 1. Department of Cardiovascular Surgery, Istanbul SBU Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Hospital, Istanbul, Turkey. 2. Department of Cardiology, Istanbul SBU Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Hospital, Istanbul, Turkey.
Abstract
BACKGROUND: Transcatheter closure is the preferred method for atrial septal defect (ASD) closure. Robotic surgery has become the least invasive technique for ASD closure. Therefore, we sought to evaluate the outcomes in patients who underwent ASD closure with transcatheter or robotic surgery techniques. METHODS: A total of 462 patients underwent totally endoscopic robotic (n = 217) or transcatheter ASD closure (n = 245). Demographic data, perioperative data, and outcomes were compared. RESULTS: The mean age was lower in the robotic surgery group than the transcatheter group (31.4 ± 11.8 vs 39.4 ± 13.2 years; P = .001). Ventilation time, intensive care unit (ICU) stay, and hospital stay was significantly lower in the transcatheter group. The postoperative new-onset neurological event was seen in one (0.5%) patient in robotic surgery, and four (1.6%) patients in the transcatheter closure group. New-onset atrial fibrillation was found to be higher in transcatheter closure (two vs seven patients; P = .133) group. Surgical conversion to a larger incision occurred in two patients (1%) in robotic surgery, while two patients (0.5%) underwent emergency median sternotomy due to device embolization to the main pulmonary artery. There was no mortality in both groups. During follow-up, one patient (0.5%) who underwent robotic surgery was reoperated, and two patients (0.8%) who underwent transcatheter procedure required surgical intervention due to device migration and severe residual shunting (P = .635). CONCLUSION: Both transcatheter and robotic surgery approaches had excellent outcomes but transcatheter closure had shorter hospital and ICU stays. Robotic surgery provides a similar complication risk that can be comparable to the transcatheter approach as well as patient comfort and cosmetic advantage over the other surgical techniques.
BACKGROUND: Transcatheter closure is the preferred method for atrial septal defect (ASD) closure. Robotic surgery has become the least invasive technique for ASD closure. Therefore, we sought to evaluate the outcomes in patients who underwent ASD closure with transcatheter or robotic surgery techniques. METHODS: A total of 462 patients underwent totally endoscopic robotic (n = 217) or transcatheter ASD closure (n = 245). Demographic data, perioperative data, and outcomes were compared. RESULTS: The mean age was lower in the robotic surgery group than the transcatheter group (31.4 ± 11.8 vs 39.4 ± 13.2 years; P = .001). Ventilation time, intensive care unit (ICU) stay, and hospital stay was significantly lower in the transcatheter group. The postoperative new-onset neurological event was seen in one (0.5%) patient in robotic surgery, and four (1.6%) patients in the transcatheter closure group. New-onset atrial fibrillation was found to be higher in transcatheter closure (two vs seven patients; P = .133) group. Surgical conversion to a larger incision occurred in two patients (1%) in robotic surgery, while two patients (0.5%) underwent emergency median sternotomy due to device embolization to the main pulmonary artery. There was no mortality in both groups. During follow-up, one patient (0.5%) who underwent robotic surgery was reoperated, and two patients (0.8%) who underwent transcatheter procedure required surgical intervention due to device migration and severe residual shunting (P = .635). CONCLUSION: Both transcatheter and robotic surgery approaches had excellent outcomes but transcatheter closure had shorter hospital and ICU stays. Robotic surgery provides a similar complication risk that can be comparable to the transcatheter approach as well as patient comfort and cosmetic advantage over the other surgical techniques.
Authors: Stepan Cerny; Wouter Oosterlinck; Burak Onan; Sandeep Singh; Patrique Segers; Cengiz Bolcal; Cem Alhan; Emiliano Navarra; Matteo Pettinari; Frank Van Praet; Herbert De Praetere; Jan Vojacek; Theodor Cebotaru; Paul Modi; Fabien Doguet; Ulrich Franke; Ahmed Ouda; Ludovic Melly; Ghislain Malapert; Louis Labrousse; Monica Gianoli; Alfonso Agnino; Tine Philipsen; Jean-Luc Jansens; Thierry Folliguet; Meindert Palmen; Daniel Pereda; Francesco Musumeci; Piotr Suwalski; Koen Cathenis; Jef Van den Eynde; Johannes Bonatti Journal: Front Cardiovasc Med Date: 2022-01-20