Atrial Septal Defect Repair

Operations for atrial septal defects are similar to those for mitral valve repairs, except that a mini-thoracotomy is not required. A closed-chest procedure is possible. Like all robotic procedures that demand entrance into the thoracic cavity, single-lung ventilation must be instituted during surgery. Atrial septal defect repairs also require opening the heart and preventing any blood from entering the heart. This

TABLE 66-2 -- Exclusion criteria for robotically assisted mitral valve repairs

Severely calcified mitral annulus

Severe pulmonary hypertension

Ischemic heart disease

Surgery requiring multiple valve repairs

Previous surgery to right hemithorax

Severe aortic and peripheral atherosclerosis

is facilitated by jugular and femoral vein cannulation and snaring the IVC and SVC. Cardiopulmonary bypass with cardioplegia administration into the aortic root is used to arrest the heart. Methods of cardiopulmonary bypass using endovascular clamping are described in "Coronary Artery Bypass Grafting." Dogan and coworkers^[29] reported the first successful closed-chest closure of an atrial septal defect.