Dang HQ, Le HT. Totally endoscopic ventricular septal defect repair using bilateral femoral arterial cannulation in an 8-year-old girl.
Int J Surg Case Rep 2019;
55:4-6. [PMID:
30641324 PMCID:
PMC6330555 DOI:
10.1016/j.ijscr.2018.12.002]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 12/14/2018] [Indexed: 11/10/2022] Open
Abstract
The scope of totally endoscopic cardiac surgery in children is limited.
Femoral cannulation has risks which increase in small children.
Bilateral femoral arterial cannulation helped to avoid vessel complication in small children.
Four small trocars (5–12 mm) were suitable for totally endoscopic VSD closure.
Introduction
There are few reports on applying totally endoscopic surgery (TES) for repairing ventricular septal defect (VSD), especially in children.
Case presentation
We described an 8-year-old girl, weighing 17 kg, who was diagnosed with peri-membranous VSD and patent ductus arteriosus (PDA). The patient had undergone trans-catheter PDA closure first, and 3 weeks later, TES was performed for VSD repair through 4 small trocars (one 12 mm trocar and three 5 mm trocars) without robotic assistance. Arterial line was set up indirectly to the right femoral artery (FA) through a graft with an additional line to the left side for reducing arterial pressure.
Discussion
FA cannulation in small children induce some risks, such as: FA trauma, critical lower limb ischaemia, and iliac or femoral arterial stenosis. Our new method of FA cannulation was safe with 13 months of follow-up. The major concerns in this case were repairing VSD through small trocars in a small child.
Conclusion
Bilateral FA cannulation and the way to set up small trocars may facilitate totally endoscopic VSD repair in small children. However, the safety and efficacy of these approaches needs to be validated by larger studies preferably randomised controlled trials.
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