Endoscopic ventricular septal defect repair: experience at a single center
Main Article Content
Abstract
Objective: To report experience with cardiopulmonary bypass (CPB) management in totally endoscopic ventricular septal defect (VSD) repair at a single center. Methods: Retrospective review of 32 patients (Jan 2024–Aug 2025). Peripheral CPB via femoral artery and bicaval venous drainage using the Seldinger technique. Heparin 300 IU/kg to achieve ACT ≥ 480 s. The circuit included an oxygenator with integrated arterial filter; vacuum-assisted venous drainage (VAVD) ≤ 40 mmHg. Custodiol-HTK cardioplegia (~120 min protection). Moderate hypothermia (~32°C), controlled rewarming. CO₂ insufflation, standardized de-airing protocol. Results: Mean CPB and cross-clamp times were 161.3 ± 49.8 and 97.9 ± 39.8 minutes. Five patients (15.6%) required an additional femoral arterial cannula due to high line pressure. Ventilation averaged 6.4 hours; ICU stay 1 day; hospital stay 10.5 days. No in-hospital mortality. Conclusions: With standardized CPB checkpoints—appropriate cannulation, arterial line filtration, VAVD ≤ 40 mmHg, Custo cardioplegia, temperature and flow control, meticulous de-airing—totally endoscopic VSD repair can be performed safely with encouraging early outcomes.
Keywords
cardiopulmonary bypass, totally endoscopic cardiac surgery, ventricular septal defect, Custodiol, VAVD, oxygenator with integrated arterial filter
Article Details
References
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