Early Outcomes of Totally Endoscopic Repair of Partial Atrioventricular Septal Defect in Adults Using A 3D Visualization System

Objective We aimed to describe the surgical technique and clinical outcomes of totally endoscopic repair of partial atrioventricular septal defect using a 3D visualization system. Methods The study included 27 patients with a mean age of 42.5 years, and a male‐to‐female ratio of 1: 2, who underwent totally endoscopic repair of partial atrioventricular septal defect using a 3D visualization system at Hanoi Heart Hospital, Vietnam, from January 2018 to June 2024. Results 77.8% of patients, who underwent mitral valve repair using anterior leaflet cleft suturing and annuloplasty using a ring, had moderate or severe mitral regurgitation when the patient had LVDd ≥ 60 mm. No patient required mitral valve replacement. 88.8% of patients underwent tricuspid valve repair using the Devega method because of moderate or severe tricuspid regurgitation. The preoperative right ventricular diameter was 36 mm and decreased to 24.5 mm postoperatively ( p < 0.001). The preoperative pulmonary artery pressure was 48 mmHg and reduced to 26.5 mmHg postoperatively ( p < 0.001). Five patients had very severe pulmonary hypertension preoperatively (mean 70.6 mmHg), which decreased to 37 mmHg after surgery ( p < 0.001). The average postoperative ventilation time was 7.8 h, the mean ICU stay was 2 days. The mean chest tube drainage volume was 202 mL. No patient required reoperation or died during follow‐up (mean 28.8 months), and 30‐day echocardiography showed significant improvements in valve function, pulmonary artery pressure, and right ventricular dimensions. Conclusion The totally endoscopic repair was safe and effective, with no early mortality or major complications and significant early improvement in valve function, pulmonary artery pressure, and right ventricular dimensions.