Robotic repair of atrial septal defect: Pre-groove vertical right atriotomy approachCentral MessagePerspective

Objective: Minimally invasive repair using robotic systems has been accepted as an attractive alternative in the surgical repair of atrial septal defects (ASDs). Clear exposure of the entire rim of the ASD is often hindered during a robotic approach. Here, we describe an approach using vertical righ...

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Main Authors: Kitae Kim, MD, Yun Seok Kim, MD, Hong Rae Kim, MD, PhD, Ho Jin Kim, MD, PhD, Jae Suk Yoo, MD, PhD, Joon Bum Kim, MD, PhD, Sung-Ho Jung, MD, PhD, Jae Won Lee, MD, PhD
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:JTCVS Techniques
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666250724002438
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author Kitae Kim, MD
Yun Seok Kim, MD
Hong Rae Kim, MD, PhD
Ho Jin Kim, MD, PhD
Jae Suk Yoo, MD, PhD
Joon Bum Kim, MD, PhD
Sung-Ho Jung, MD, PhD
Jae Won Lee, MD, PhD
author_facet Kitae Kim, MD
Yun Seok Kim, MD
Hong Rae Kim, MD, PhD
Ho Jin Kim, MD, PhD
Jae Suk Yoo, MD, PhD
Joon Bum Kim, MD, PhD
Sung-Ho Jung, MD, PhD
Jae Won Lee, MD, PhD
author_sort Kitae Kim, MD
collection DOAJ
description Objective: Minimally invasive repair using robotic systems has been accepted as an attractive alternative in the surgical repair of atrial septal defects (ASDs). Clear exposure of the entire rim of the ASD is often hindered during a robotic approach. Here, we describe an approach using vertical right atriotomy along the interatrial groove that may enhance the exposure of the ASD. Methods: Patients who underwent ASD closure using the da Vinci Si surgical ystem (Intuitive Surgical) from 2007 to 2021 were included. During ASD closure procedures, right atriotomy was performed either conventionally in an oblique manner or parallel to the interatrial groove. A comparative analysis was performed in terms of all-cause mortality, complications, and durations of cardiopulmonary bypass, aortic crossclamp, intensive care unit stay, and hospital stay. The inverse probability of treatment weighting was utilized to balance baseline characteristics across different surgical approaches. Results: A total of 114 consecutive patients (mean age, 38.7 ± 12.8 years) constituted the study cohort. There were no cases of mortality or surgical complications in either group. After adjusting for potential covariates, the cardiopulmonary bypass (92.8 ± 31.5 minutes vs 143.1 ± 40.7 minutes) and aortic crossclamp (30.7 ± 21.3 minutes vs 60.8 ± 23.5 minutes) times were significantly shorter in the group using vertical right atriotomy than in the group using conventional approach (P < .001 for both). Conclusions: Performing vertical right atriotomy adjacent to the interatrial groove optimized ASD exposure compared with the conventional approach during robotic ASD repair, leading to reduced cardiopulmonary bypass and aortic crossclamp times.
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spelling doaj-art-5b8e34c6f47c4ce29d30c84fe4b01fb62025-08-20T03:38:24ZengElsevierJTCVS Techniques2666-25072024-12-0128738110.1016/j.xjtc.2024.05.022Robotic repair of atrial septal defect: Pre-groove vertical right atriotomy approachCentral MessagePerspectiveKitae Kim, MD0Yun Seok Kim, MD1Hong Rae Kim, MD, PhD2Ho Jin Kim, MD, PhD3Jae Suk Yoo, MD, PhD4Joon Bum Kim, MD, PhD5Sung-Ho Jung, MD, PhD6Jae Won Lee, MD, PhD7Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South KoreaDepartment of Thoracic and Cardiovascular Surgery, Keimyung Medical Center, University of Keimyung College of Medicine, Daegu, South KoreaDepartment of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South KoreaDepartment of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South KoreaDepartment of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South KoreaDepartment of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South KoreaDepartment of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South KoreaDepartment of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Bucheon-si, Gyeonggi-do, South Korea; Address for reprints: Jae Won Lee, MD, PhD, Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, 28, Hohyeon-ro 489beon-gil, Sosa-gu, Bucheon, 14754, South Korea.Objective: Minimally invasive repair using robotic systems has been accepted as an attractive alternative in the surgical repair of atrial septal defects (ASDs). Clear exposure of the entire rim of the ASD is often hindered during a robotic approach. Here, we describe an approach using vertical right atriotomy along the interatrial groove that may enhance the exposure of the ASD. Methods: Patients who underwent ASD closure using the da Vinci Si surgical ystem (Intuitive Surgical) from 2007 to 2021 were included. During ASD closure procedures, right atriotomy was performed either conventionally in an oblique manner or parallel to the interatrial groove. A comparative analysis was performed in terms of all-cause mortality, complications, and durations of cardiopulmonary bypass, aortic crossclamp, intensive care unit stay, and hospital stay. The inverse probability of treatment weighting was utilized to balance baseline characteristics across different surgical approaches. Results: A total of 114 consecutive patients (mean age, 38.7 ± 12.8 years) constituted the study cohort. There were no cases of mortality or surgical complications in either group. After adjusting for potential covariates, the cardiopulmonary bypass (92.8 ± 31.5 minutes vs 143.1 ± 40.7 minutes) and aortic crossclamp (30.7 ± 21.3 minutes vs 60.8 ± 23.5 minutes) times were significantly shorter in the group using vertical right atriotomy than in the group using conventional approach (P < .001 for both). Conclusions: Performing vertical right atriotomy adjacent to the interatrial groove optimized ASD exposure compared with the conventional approach during robotic ASD repair, leading to reduced cardiopulmonary bypass and aortic crossclamp times.http://www.sciencedirect.com/science/article/pii/S2666250724002438atrial septal defectrobotic surgeryright atriotomyinteratrial groove
spellingShingle Kitae Kim, MD
Yun Seok Kim, MD
Hong Rae Kim, MD, PhD
Ho Jin Kim, MD, PhD
Jae Suk Yoo, MD, PhD
Joon Bum Kim, MD, PhD
Sung-Ho Jung, MD, PhD
Jae Won Lee, MD, PhD
Robotic repair of atrial septal defect: Pre-groove vertical right atriotomy approachCentral MessagePerspective
JTCVS Techniques
atrial septal defect
robotic surgery
right atriotomy
interatrial groove
title Robotic repair of atrial septal defect: Pre-groove vertical right atriotomy approachCentral MessagePerspective
title_full Robotic repair of atrial septal defect: Pre-groove vertical right atriotomy approachCentral MessagePerspective
title_fullStr Robotic repair of atrial septal defect: Pre-groove vertical right atriotomy approachCentral MessagePerspective
title_full_unstemmed Robotic repair of atrial septal defect: Pre-groove vertical right atriotomy approachCentral MessagePerspective
title_short Robotic repair of atrial septal defect: Pre-groove vertical right atriotomy approachCentral MessagePerspective
title_sort robotic repair of atrial septal defect pre groove vertical right atriotomy approachcentral messageperspective
topic atrial septal defect
robotic surgery
right atriotomy
interatrial groove
url http://www.sciencedirect.com/science/article/pii/S2666250724002438
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