# Minimally Invasive Approach for Superior Sinus Venosus Atrial Septal Defect Repair in a Child: A Case Report

## TL;DR

A 12-year-old child successfully had a heart defect repaired using a minimally invasive surgical technique, avoiding traditional open chest surgery.

## Contribution

This case report presents a successful minimally invasive repair of a sinus venosus atrial septal defect in a pediatric patient.

## Key findings

- Minimally invasive repair via right mini-thoracotomy is viable for pediatric patients weighing at least 20 kg.
- Direct cannulation of the superior vena cava facilitated successful surgical intervention.
- The anatomical bay in the right atrium improved exposure for precise defect correction.

## Abstract

In recent years, breakthroughs in transcatheter interventions have transformed the landscape of cardiac disease management, where less invasive techniques have gained popularity due to their aesthetic benefits. Yet, when it comes to sinus venosus atrial septal defects (ASDs), the intricate anatomical challenges have largely limited the adoption of minimally invasive surgical solutions in these cases. Reports of minimally invasive repair for this particular defect have been sparse, and most such cases involve adult patients. In this account, we detail the management of a 12-year-old child who successfully underwent correction of the defect via a right mini-thoracotomy. This technique eliminates the need for direct cannulation of the central aorta and inferior vena cava, thus maintaining a clear operative field. Repair through right mini-thoracotomy and femoral cannulation is a viable option for pediatric patients weighing at least 20 kg, providing an effective alternative to the traditional midsternotomy. Superior vena cava (SVC) drainage pre-insertion of partial anomalous pulmonary venous connection (PAPVC) was done through direct cannulation of the SVC. Notably, the distinct bay formed within the right atrium over a superiorly located defect enhances exposure to the SVC, pulmonary veins, and ASD, facilitating precise surgical intervention.