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Robotic repair of partial anomalous pulmonary venous connection: the initial experience and technical details

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Abstract

This study reports our initial experience with robotic-assisted partial anomalous pulmonary venous connection (PAPVC) repair. From May 2013 through September 2018, 20 patients (12 male and 8 female) underwent robotic-assisted repair of a right-sided (n = 19) or a left-sided (n = 1) PAPVC. The mean age was 24.6 ± 9.4 years (range 14–44) and the mean body mass index was 22.3 ± 4.6. Seventeen patients had a right-sided supra-cardiac PAPVC with sinus venosus atrial septal defect, two had a right-sided cardiac PAPVC to the right atrium and one had a left-sided cardiac PAPVC to the coronary sinus. Associated anomalies included patent foramen ovale (n = 2) and left persistent superior vena cava (n = 1). All patients were operated on successfully. No conversion to mini-thoracotomy or sternotomy was needed. Cardiopulmonary bypass and aortic clamping times were 114.8 ± 17.3 (range 90–150) and 66.5 ± 15.8 (range 44–90) minutes, respectively. Repair techniques included the single-patch repair with baffle through right atriotomy (n = 16), the 2-patch repair (n = 1) using lateral transcaval incision and intracardiac re-routing (n = 3). The mean ventilation time was 4.2 ± 1.2 h and hospital stay was 3.1 ± 0.1 days. No phrenic nerve injury, sinus node dysfunction, re-exploration or blood transfusion was noted. No residual shunting or venous obstruction was found on echocardiograms. Follow-up was a mean of 1.7 years (range 3–36 months). There was no follow-up mortality. Totally, endoscopic robotic-assisted PAPVC repair is a feasible procedure in selected adult patients. It is a less invasive alternative to traditional incisions, mini-thoracotomy and endoscopic approaches. In the future, new generation robotic devices may offer an alternative for younger patients with this pathology.

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, University of Health Sciences, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey

    Burak Onan, Unal Aydin, Ersin Kadirogullari, Ismihan Selen Onan & Onur Sen

  2. Department of Anesthesiology and Reanimation, University of Health Sciences, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey

    Zeynep Kahraman

Authors
  1. Burak Onan
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  2. Unal Aydin
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  3. Ersin Kadirogullari
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  4. Ismihan Selen Onan
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  5. Onur Sen
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  6. Zeynep Kahraman
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Correspondence to Burak Onan.

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Burak Onan, MD, Unal Aydin, MD, Ersin Kadirogullari, MD, Ismihan Selen Onan, MD, Onur Sen, and Zeynep Kahraman declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Onan, B., Aydin, U., Kadirogullari, E. et al. Robotic repair of partial anomalous pulmonary venous connection: the initial experience and technical details. J Robotic Surg 14, 101–107 (2020). https://doi.org/10.1007/s11701-019-00943-0

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  • DOI: https://doi.org/10.1007/s11701-019-00943-0

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