Horizontal Right Axillary Minithoracotomy: Aesthetic and Effective Option for Atrial and Ventricular Septal Defect Repair in Infants and Toddlers

Overview

Journal Rev Bras Cir Cardiovasc

Specialty Cardiology & Vascular Diseases

Date 2014 Aug 21

PMID 25140460

Citations 4

Authors

Luciana da Fonseca Da Silva

Jose Pedro Da Silva

Aida L R Turquetto

Sonia Meiken Franchi

Cybelle M Cascudo

Rodrigo Moreira Castro

Walter Jose Gomes

Christian Schreiber

Affiliations

Soon will be listed here.

Abstract

Introduction: Congenital heart defects treatment shows progressive reduction in morbidity and mortality, however, the scar, resulting from ventricular (VSD) and atrial septal defect (ASD) repair, may cause discomfort. Right axillary minithoracotomy approach, by avoiding the breast growth region, is an option for correction of these defects that may provide better aesthetic results at low cost. Since October 2011, we have been using this technique for repairing VSD and ASD defects as well as associated defects.

Objectives: To evaluate the efficacy of this method in children undergoing correction of VSD and ASD, to compare perioperative clinical outcomes with those repaired by median sternotomy, and to evaluate the aesthetic result.

Methods: Perioperative clinical data of 25 patients submitted to axillary thoracotomy were compared with data from a paired group of 25 patients with similar heart defects repaired by median sternotomy, from October 2011 to August 2012.

Results: Axillary approach was possible even in infants. There was no mortality and the main perioperative variables were similar in both groups, except for lower use of blood products in the axillary group (6/25) vs. control (13/25), with statistical difference (P =0.04). The VSD size varied from 7 to 15 mm in axillary group. Cannulation of the aorta and vena cavae was performed through the main incision, whose size ranged from 3 to 5 cm in the axillary group, with excellent aesthetic results.

Conclusion: The axillary thoracotomy was effective, allowing for a heart defect repair similar to the median sternotomy, with more satisfactory aesthetic results and reduced blood transfusion, and it can be safely used in infants.

Citing Articles

Right vertical axillary incision vs. median sternotomy for congenital ventricular septal defect repair in children: a propensity score-matched study.

Liu L, Wang C, Dong J, Lin J, Liu M, Li W Front Cardiovasc Med. 2025; 11():1527042.

PMID: 39839833 PMC: 11747392. DOI: 10.3389/fcvm.2024.1527042.

"Invisible" Incision: Modified Horizontal Right Axillary Mini-Thoracotomy for Pediatric Cardiac Surgery.

Watanabe N, Hapak A, Nasirov T Ann Thorac Surg Short Rep. 2025; 1(1):99-101.

PMID: 39790541 PMC: 11708669. DOI: 10.1016/j.atssr.2022.07.005.

Analysis of the therapeutic effect of right mid-axillary approach in the surgical treatment of ASD and VSD in children.

Li F, Cheng T, Yan M, Li T, Zhang T, Huang Y J Cardiothorac Surg. 2024; 19(1):587.

PMID: 39363311 PMC: 11448023. DOI: 10.1186/s13019-024-03105-y.

Rightvertical axillary incision for atrial septal defect: a propensity score matched study.

Yang X, Hu Y, Dong J, Huang P, Luo J, Yang G J Cardiothorac Surg. 2022; 17(1):256.

PMID: 36199116 PMC: 9535985. DOI: 10.1186/s13019-022-01999-0.

Repair of ventricular septal defect and pulmonary stenosis with right lateral mini-thoracotomy.

Temur B, Erek E Turk Gogus Kalp Damar Cerrahisi Derg. 2020; 28(3):555-556.

PMID: 32953224 PMC: 7493614. DOI: 10.5606/tgkdc.dergisi.2020.19203.

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