Minimally invasive techniques for congenital heart surgery.

Minimally invasive techniques in congenital heart surgery have evolved steadily over the past 5 years. Initially, instrumentation and techniques were adopted from other subspecialties, and efforts were directed at simple extracardiac repairs. These efforts established the safety and efficacy of video-assisted endoscopic techniques for pediatric cardiac surgery. As instruments and techniques evolved, intraoperative cardioscopy became feasible and showed the utility of these new imaging techniques in facilitating open cardiac repairs by exposing remote areas within the heart. This experience has laid a foundation for the next phase of minimally invasive pediatric cardiac surgery: the repair of complex congenital defects.