Concomitant atrial septal defect closure and tricuspid repair using the da Vinci robotic system

摘要

A 33-year-old female patient presented with exertional dyspnea. Physical examination revealed 3/6 grade systolic murmur over the pulmonary area. Transthoracic echocardiography revealed large secundum atrial septal defect (ASD) with extension toward the superior vena cava, moderate (3+) tricuspid regurgitation, and dilated right cardiac chambers. Tricuspid valve annulus was 42 mm. Transesophageal echocardiography confirmed secundum ASD with a deficient rim superiorly and tricuspid regurgitation. The operation was performed under general anesthesia and using the da Vinci system (Intuitive Surgical, Inc., Sunnyvale, CA, USA). Car-diopulmonary bypass was established through the femoral artery, femoral vein, and jugular vein. Cardiac arrest was established using antegrade blood cardioplegia. After right atriotomy, the tricuspid valve was exposed using the Endowrist atrial retractor (Intuitive Surgical, Inc.).