Surgical Repair Via Submammary Thoracotomy, Right Axillary Thoracotomy and Median Sternotomy for Ventricular Septal Defects

Overview

Journal J Cardiothorac Surg

Publisher Biomed Central

Specialties Cardiology & Vascular Diseases
General Surgery
Pulmonary Medicine

Date 2018 May 23

PMID 29783998

Citations 7

Authors

Zhi-Nuan Hong

Qiang Chen

Ze-Wei Lin

Gui-Can Zhang

Liang-Wan Chen

Qi-Liang Zhang

Hua Cao

Affiliations

Soon will be listed here.

Abstract

Background: Right submammary thoracotomy and right vertical infra-axillary thoracotomy are performed for ventricular septal defect (VSD) to reduce the invasiveness of the conventional surgical repair through median sternotomy approach. No comparative studies have been conducted among these three procedures.

Methods: From January 2016 to December 2016, 182 patients with isolated VSD who underwent surgical repair via one of these 3 approaches were reviewed to compare these three procedures.

Results: The procedure success rates were similar in these three groups. There was no statistically significant difference in operative time, aortic cross-clamping time, the duration of CPB, blood transfusion amount and medical cost. However, postoperative mechanical ventilation time, the duration of intensive care and postoperative length of hospital stay were longer in median sternotomy group than the other two groups. (P < 0.05) The median sternotomy group required the longest incision. No significant difference was noted in major adverse events. There were different advantages and disadvantages in the three kinds of operative procedures.

Conclusions: Regarding conventional surgical repair VSD, right submammary thoracotomy and right vertical infra-axillary thoracotomy both delivered better cosmetic results for patients with isolated VSD, while all the three procedures could obtain satisfactory clinical effect.

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.

Right thoracotomy with central cannulation for valve surgery: 10 years of experience.

Sharma A, Dixit S, Sharma M, Mittal S, Shah A, Goyal S J Cardiothorac Surg. 2024; 19(1):597.

PMID: 39380051 PMC: 11459693. DOI: 10.1186/s13019-024-02945-y.

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.

Minimal invasive approaches for pediatric & congenital heart surgery: safe, reproducible, more cosmetic than through sternotomy, and here to stay.

Dodge-Khatami J, Dodge-Khatami A, Nguyen T, Ruffer A Transl Pediatr. 2023; 12(9):1744-1752.

PMID: 37814714 PMC: 10560358. DOI: 10.21037/tp-23-282.

Doubly committed ventricular septal defect: Is it safe to perform surgical closure through the pulmonary trunk approached by right vertical axillary thoracotomy?.

Nguyen U, Nguyen T, Kotani Y, Nguyen M, Mai D, Nguyen V JTCVS Open. 2023; 15:368-373.

PMID: 37808014 PMC: 10556957. DOI: 10.1016/j.xjon.2023.06.012.

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