Robotically assisted perventricular closure of perimembranous ventricular septal defects: preliminary results in Yucatan pigs.

摘要: Objective Robotic systems allow surgeons to perform minimally invasive cardiac surgery in adults. Experience the pediatric population, however, is limited. Perventricular closure of muscular ventricular septal defects has been reported humans but requires a median sternotomy. The objective this study was assess feasibility robotically assisted perimembranous by using perventricular approach. Methods procedure attempted 7 pigs with naturally occurring defects. Echocardiography performed confirm presence and size defect. A 3-armed da Vinci system consisting two 8-mm instrument ports 12-mm endoscopy port used. pericardiotomy performed, right free wall visualized. spinal needle advanced into cavity. By echocardiographic guidance, glide wire through angiocatheter manipulated defect left ventricle or ascending aorta. delivery sheath over wire. An appropriately sized Amplatzer device deployed sheath. Results successful 5 pigs. One removed because it smaller than an not available. placement failed second pig series. Four were followed up for 1 4 months. Angiograms before killed documented complete occlusion 3 mild-to-moderate shunt 1. Conclusions Robotically Membranous VSD Occluder feasible. This approach avoids associated morbidities cardiopulmonary bypass Further investigation refinements are needed, application humans.