Vertical Right Axillary Mini-Thoracotomy for Correction of Ventricular Septal Defects and Complete Atrioventricular Septal Defects.

Abstract

BACKGROUND:

Vertical right axillary mini-thoracotomy (VRAMT) is the standard approach for correction of atrial septal defect and partial atrioventricular septal defect at our institution. This observational single-center study compares our initial results with the VRAMT approach for the repair of ventricular septal defect (VSD) and complete atrioventricular septal defect (CAVSD) in infants and children to an approach using standard median sternotomy (MS).

METHODS:

The perioperative courses of patients undergoing VSD and CAVSD correction through either a VRAMT or an MS were analyzed retrospectively. The surgical technique for the VRAMT involved a 4- to 5-cm vertical incision in the right axillary fold.

RESULTS:

Of 84 patients, 25 (VSD, n = 15; CAVSD, n = 10) underwent correction through a VRAMT approach, whereas 59 (VSD, n = 35; CAVSD, n = 24) had repair through MS. VSD and CAVSD groups were comparable with respect to age and weight. No significant differences were observed for aortic cross-clamp duration, intensive care unit stay, hospital stay, and echocardiographic follow-up. There was no need for any conversion from VRAMT to MS in any case. Neither wound infections nor thoracic deformities were observed in both groups.

CONCLUSIONS:

VRAMT can be considered as a safe and effective approach for the repair of VSD and CAVSD in selected patient groups, and the outcome data appear comparable to those of MS.

• Authors: Paul Philipp Heinisch, Marc Wildbolz, Maria Julia Beck, Maris Bartkevics, Brigitta Gahl, Balthasar Eberle, Gabor Erdoes, Hans-Joerg Jenni, Florian Schoenhoff, Jean-Pierre Pfammatter, Thierry Carrel, Alexander Kadner
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 106 Issue 4 Pg. 1220-1227 (10 2018) ISSN: 1552-6259 [Electronic] Netherlands
• PMID: 29859151 (Publication Type: Comparative Study, Journal Article, Observational Study)
• Copyright: Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Topics

• Academic Medical Centers
• Age Factors
• Axilla (surgery)
• Chi-Square Distribution
• Child
• Child, Preschool
• Cohort Studies
• Confidence Intervals
• Echocardiography (methods)
• Female
• Follow-Up Studies
• Heart Septal Defects (diagnostic imaging, mortality, surgery)
• Heart Septal Defects, Ventricular (diagnostic imaging, mortality, surgery)
• Humans
• Infant
• Male
• Minimally Invasive Surgical Procedures (adverse effects, methods)
• Patient Positioning
• Patient Safety
• Patient Selection
• Retrospective Studies
• Risk Assessment
• Sternotomy (adverse effects, methods)
• Switzerland
• Thoracotomy (adverse effects, methods)
• Treatment Outcome