Short-term outcomes of minimally invasive open-heart surgery in children at Cho Ray Hospital

Abstract

Background: Minimally invasive surgery has emerged as a major developmental trend in open-heart surgery worldwide over the past two decades. In Viet Nam, minimally invasive open-heart surgery in pediatric patients has been developing since 2014 and is currently performed at several major cardiovascular centers. This study reports the early outcomes of minimally invasive open-heart surgery in children at Cho Ray Hospital.

Objective: To evaluate the early outcomes of minimally invasive cardiac surgery in pediatric patients at Cho Ray Hospital.

Methods: A retrospective descriptive study was conducted by reviewing medical records of pediatric patients with congenital or acquired heart diseases who underwent surgery at the Pediatric Cardiac Surgical Intensive Care Unit, Cho Ray Hospital, from January 2020 to December 2025. Surgical approaches did not involve full median sternotomy and were performed with cardiopulmonary bypass support. Patients with isolated patent ductus arteriosus or isolated coarctation of the aorta were excluded.

Results: A total of 40 pediatric patients underwent minimally invasive open-heart surgery, including 24 females (60%). The mean age at operation was 6.8 years (range: 3 months to 15 years), with a mean body weight of 25.5 kg (range: 4.7–65 kg). Preoperative diagnoses were ventricular septal defect in 23 patients (57.5%), atrial septal defect in 13 patients (32.5%), mitral regurgitation in 2 patients (5%), cor triatriatum in 1 patient (2.5%), and left atrial myxoma in 1 patient (2.5%). Minimally invasive surgical approaches included lower partial sternotomy in 11 patients (27.5%), right submammary thoracotomy in 18 patients (45%), and right vertical axillary thoracotomy in 11 patients (27.5%). The mean postoperative length of hospital stay was 19.8 days (range: 6–39 days). Early postoperative outcomes were favorable, with no in-hospital mortality, no reoperations, and no atrioventricular block requiring permanent pacemaker implantation (0%). Postoperative complications were infrequent, consisting of pneumothorax in 2.5% of patients and surgical site infection in 2.5%.

Conclusion: In this study, the complication rate was very low, and no mortality was observed. Cardiac lesions were completely repaired, with no significant residual defects detected on postoperative echocardiography. Minimally invasive open-heart surgery in pediatric patients at Cho Ray Hospital demonstrated good and safe short-term outcomes. Minimally invasive open-heart surgery in pediatric patients performed at Cho Ray Hospital is safe and associated with favorable short-term outcomes.