DOI: https://doi.org/10.14710/jai.v0i0.70958

Anesthesia for ASD Closure in Robotic-Assisted Cardiac Surgery: A Case Report

Rumah Sakit Jantung Pembuluh Darah Harapan Kita, KSM Anestesi Bedah Kardiovaskular, Indonesia

Received: 2 Sep 2025; Revised: 4 Nov 2025; Accepted: 11 Nov 2025; Available online: 9 Jan 2026.
Open Access Copyright 2021 JAI (Jurnal Anestesiologi Indonesia)
Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 International License.

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Abstract

Background: Minimally invasive cardiac surgery is a surgical approach performed through small incisions in the chest without the need for a sternotomy. Robotic technology is one of the techniques that can be utilized in this type of surgery. This approach offers several advantages, including faster healing, reduced stress response, shorter hospital stays, and improved cosmetic outcomes.

Case: A 51-year-old male with an atrial septal defect (ASD) secundum and a left-to-right (L-R) shunt measuring 22x29 mm, without comorbidities, was scheduled for general anesthesia. The patient was classified as ASA III. Monitors applied included ECG, nasopharyngeal thermometer, arterial line, CVP, EtCO₂, NIRS, and TEE. The patient was placed in a supine position and intubated with a 37 Fr left-sided double-lumen endotracheal tube (DLT) at a depth of 31 cm, followed by one-lung ventilation. General anesthesia was induced using midazolam 5 mg, sufentanil 10 mcg, propofol 50 mg, and rocuronium 50 mg, maintained with 1% sevoflurane and rocuronium at 10 mg/hour. A regional block was performed using a Deep Serratus Anterior Plane Block with a regimen of 10 ml of 0.5% isobaric bupivacaine (50 mg), 5 ml of 10% lignocaine (500 mg), and epinephrine 1:200,000, with a total volume of 40 ml. The surgery was performed on a beating heart with right femoral artery, right femoral vein, and right jugular vein cannulation. The procedure lasted 12 hours.

Discussion: Robot-assisted minimally invasive cardiac surgery greatly aids cardiac surgeons in performing procedures with high precision. However, it is essential to consider the potential risks and complications associated with the surgery. Anesthesiologists must enhance preoperative, intraoperative, and postoperative assessments while ensuring effective communication among the surgical team.

Conclusion: Robot-assisted minimally invasive cardiac surgery can be used as a primary surgical method for ASD closure. However, anesthesiologists must pay close attention to preoperative, intraoperative, and postoperative assessments to ensure patient safety and optimal outcomes.

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Keywords: Atrial Septal Defect; Cardiac Robotic Surgery; Deep Serratus Anterior Plane Block; Minimal Invasive Robotic Cardiac Surgery; One Lung Ventilation

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Section: Case Reports
Language : EN
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