Chuan-Xian Hu1, Juan Tan1, Sheng Chen1, Hui Ding1, Zhi-Wei Xu2. 1. Department of Cardiothoracic Surgery, Huai'an First People's Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 223300, China. 2. Department of Cardiothoracic Surgery, Zhejiang Normal University, Jinhua, Zhejiang, 321004, China. Electronic address: jcm025@126.com.
Abstract
OBJECTIVE: To compare the clinical outcomes of minimally invasive right subaxillary vertical thoracotomy and traditional median sternotomy through right atrium in treatment of common congenital heart diseases. METHODS: Clinical data of 59 cases of common congenital heart diseases treated with minimally invasive right axillary vertical thoracotomy from May, 2011 to February, 2013 and 77 cases of same diseases with traditional median sternotomy in the past three years were retrospectively analyzed, including atrial septal defect, membranous ventricular septal defect and partial endocardial cushion defect. The results were compared from the two groups, including the time for operation and cardiopulmonary bypass, amount of blood transfusion, postoperative drainage, ventilation time, hospital stay, and prognosis. RESULTS: No severe complications happened in both groups, like deaths or secondary surgery caused by bleeding. No significant differences were in CPB time and postoperative ventilator time between groups (P>0.05), while for all of the operative time, the length of incision, postoperative drainage and hospital stay, minimally invasive right axillary vertical thoracotomy was superior to median sternotomy, with statistically significant differences (P<0.05). In six-month followup after operation, no complications of residual deformity and pericardial effusion were found in both groups by doing echocardiography, but mild pectus carinatum was found in 8 patients in the traditional median sternotomy group (traditional group), whereas patients in another group were well recovered. CONCLUSIONS: Minimally invasive right subaxillary vertical thoracotomy for common congenital heart diseases is as safe as traditional median sternotomy, without the increasing incidence of postoperative complications. Additionally, compared with traditional median sternotomy, minimally invasive right subaxillary vertical thoracotomy is better in the aspects of hidden incision, appearance, and postoperative recovery.
OBJECTIVE: To compare the clinical outcomes of minimally invasive right subaxillary vertical thoracotomy and traditional median sternotomy through right atrium in treatment of common congenital heart diseases. METHODS: Clinical data of 59 cases of common congenital heart diseases treated with minimally invasive right axillary vertical thoracotomy from May, 2011 to February, 2013 and 77 cases of same diseases with traditional median sternotomy in the past three years were retrospectively analyzed, including atrial septal defect, membranous ventricular septal defect and partial endocardial cushion defect. The results were compared from the two groups, including the time for operation and cardiopulmonary bypass, amount of blood transfusion, postoperative drainage, ventilation time, hospital stay, and prognosis. RESULTS: No severe complications happened in both groups, like deaths or secondary surgery caused by bleeding. No significant differences were in CPB time and postoperative ventilator time between groups (P>0.05), while for all of the operative time, the length of incision, postoperative drainage and hospital stay, minimally invasive right axillary vertical thoracotomy was superior to median sternotomy, with statistically significant differences (P<0.05). In six-month followup after operation, no complications of residual deformity and pericardial effusion were found in both groups by doing echocardiography, but mild pectus carinatum was found in 8 patients in the traditional median sternotomy group (traditional group), whereas patients in another group were well recovered. CONCLUSIONS: Minimally invasive right subaxillary vertical thoracotomy for common congenital heart diseases is as safe as traditional median sternotomy, without the increasing incidence of postoperative complications. Additionally, compared with traditional median sternotomy, minimally invasive right subaxillary vertical thoracotomy is better in the aspects of hidden incision, appearance, and postoperative recovery.