Pediatric heart surgery minimally invasive: experience of a Colombian center

Keerby Hernández, Servicio de Cardiología Pediátrica, Universidad Pontificia Bolivariana, Medellín, Colombia
Diana Fajardo, Servicio de Cirugía Cardiaca, Clínica Cardio VID, Medellín, Colombia
Luis H. Díaz, Servicio de Cardiología Pediátrica Hemodinamista, Clínica Cardio VID, Medellín, Colombia
Miguel Ruz, Servicio de Cardiología Pediátrica Intensivista, Clínica Cardio VID, Medellín, Colombia
Jorge Zapata- Sanchez, Cardiovascular Surgery Department, Universidad Pontificia Bolivariana, Clínica cardioVID, Medellín, Colombia
Isabel Sánchez, Servicio de Pediatría, Universidad Pontificia Bolivariana, Medellín. Colombia
Pablo Vásquez, Facultad de Pediatría, Universidad Nacional de Colombia. Medellín, Colombia

Objective: During the last decades, cardiac surgery has revolutionized, there is a growing interest in minimizing the physical aggression of surgical procedures, seeking a quick recovery, minimally invasive approaches have been a trend in recent years, with safety and efficacy equivalent to traditional techniques sternotomy. The objective of this study is to compare clinical results between pediatric patients with congenital heart disease undergoing minimally invasive surgery versus standard sternotomy. Methods: Case-control study, nested in a retrospective cohort. All pediatric patients over 10 kg in weight were included, between 2014 and 2019 who underwent surgical correction of simple congenital heart disease, in a cardiovascular center in Medellin. A case was defined as one that underwent a minimally invasive approach (MICS) and control patients who were approached in a conventional manner (CONV). 122 patients were admitted, with a mean age (MICS: 6, 4-12 vs. CONV: 5, 2-8 years). No differences were found in the baseline characteristics of both groups. No statistically significant difference was documented in infusion times (MICS: 67 min [50-90] vs. CONV: 53 min [42-90]; p = 0.54), nor differences in complications (MICS: 7.4 vs. CONV: 8.8%; p = 0.77). MICS patients had lactate on admission and a shorter ICU stay than controls. Conclusion: The MICS approach turns out to be a novel, less invasive, safe and efficient technique compared to the conventional surgical approach for the repair of simple congenital heart disease in pediatric patients.

Keywords: Thoracic surgery. Congenital heart disease. Thoracotomy sternotomy.