Just after easing of lockdown in Male’, a 26 year old female, recently married had presented to ADK hospital. She had  been having shortness of breath for the past few months, more so on walking and physical exertion. She had been been assessed by a cardiologist and was diagnosed to have Atrial Septal Defect (ASD), Ostium Secundum with chambers of the right side of the heart dilated due to overload. Trans-esophageal echocardiography was done and diagnosis confirmed. The ASD was found to be large and not amenable for device closure. It was determined that closure of the hole (ASD) in the heart should be done, to prevent it from causing her heart to suffer further, a process that could lead to heart failure, especially during a future pregnancy.

 

An additional risk of a sudden thromboembolic event was also considered. Considering her age and female gender, Cardithoracic and vascular surgeons decided to do the surgical procedure through a “keyhole” surgery on the right side of chest; a mini-invasive cardiac surgery instead of the usual midline sternotomy during which the entire breastbone (sternum) is cut in to two halves and separated to get access to the heart. 

 

The procedure went ahead as planned and the ASD repaired. Patient has made a complete recovery very quickly and is being discharged home on the 4th day after surgery.

 

Conventionally cardiac surgery, done by opening the sternum, requires patient to stay in hospital for longer period, increasing cost of care, leaves a long scar on chest, takes many weeks for the rejoined sternum to be heal and delays return to normal activity. Minimal invasive cardiac surgery (keyhole cardiac surgery) is done through a small incision on chest, which decreases pain, causes less bleeding, has a lower risk of infection, and provides better cosmetic outcome. Patients can also be discharged earlier and recover quickly, allowing earlier return to day to day activities and work.