Minimally invasive atrial septal defect closure.

Atrial septal defect (ASD) is the most common congenital cardiac disorder requiring intervention. Nowadays, most defects are closed percutaneously, but there will always remain defects that have to be closed surgically. In the past, techniques other than the standard median sternotomy approach have been advocated such as axial thoracotomy, lateral thoracotomy and limited sternotomy. In the last years, an increasing number of techniques of video-assisted mini-thoracotomy or full thoracoscopic methods including robotic-assisted operations have been described. Here, we describe and illustrate our experience with a video-assisted approach using femoral cannulation and a small thoracotomy for closure of an ASD. With this method, it is easy to perform a (additional) tricuspid valve operation at the same time, should this be indicated.