Comparison between minimal right vertical infra-axillary thoracotomy and standard median sternotomy for repair of atrial septal defects

Yaliniz, Hafize; Topcuoglu, Mehmet Sah; Göçen, Uğur; Atalay, Atakan; Keklik, Vecih; Basturk, Yuksel; Güneş, Yasemin; Türktan, Mediha; Salih, Orhan Kemal

doi:10.1016/j.asjsur.2015.01.008

Cited by 21 publications

(21 citation statements)

References 12 publications

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“…RVIAT is associated with significantly fewer blood transfusions and less chest drainage, most likely because of the avoidance of a sternotomy, which might contribute to the quick recovery. In addition, as show in our follow, the use of RVIAT did not increase the incidence of early complications, and the visual analogue scale score used to measure postoperative pain did not indicate that the spreading of the ribs was more painful than a sternotomy 18 , 19 . Furthermore, RVIAT did not influence the results of the coughing exercise after surgery, which was beneficial for early rehabilitation.…”

Section: Discussionsupporting

confidence: 66%

Early- and Long-term Outcomes of Cardiovascular Surgery via Minimal Right Vertical Infra-axillary Thoracotomy: A 15-year Study of 1,126 Patients

Wang

et al. 2018

Sci Rep

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This study reviews our results and experience with cardiothoracic surgery via RVIAT over the past 15 years. This retrospective overview summarises our results, describing the early and late clinical outcomes of 1,126 patients, including 370 ASD closures, 488 VSD closures and 268 valve surgeries, at a single center between October 2001 and December 2015. The mean follow-up time was 52 ± 35 months (range 8–120 months). The mean incision length was 6 ± 2.22 cm (range 3.9–8.9 cm). No patient required conversion to median sternotomy. All patients were satisfied with the cosmetic results at the follow-up assessment. No chest deformity or asymmetrical development of the breast was observed. Although there was no severe morbidity and operative mortality, ten late deaths occurred, 8 of which were due to cardiac causes and the other 2 to non-cardiac causes. RVIAT offers encouraging short- and long-term patient survival results and is a safe and reproducible approach with excellent late results. RVIAT should be considered as an alternative to conventional median sternotomy.

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Section: Discussionsupporting

confidence: 66%

Early- and Long-term Outcomes of Cardiovascular Surgery via Minimal Right Vertical Infra-axillary Thoracotomy: A 15-year Study of 1,126 Patients

Wang

et al. 2018

Sci Rep

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“…This incision is associated with significantly fewer blood transfusions and less chest drainage, most likely from avoiding more extensive and time-consuming dissection of adhesions, which also might contribute to the quick recovery. As shown in our follow-up data, the use of the right infraaxillary incision did not increase the incidence of the early complications, and the visual analogue scale score used to measure postoperative pain did not indicate that the spreading of the ribs was more painful than in a sternotomy [Yaliniz 2015, Luo 2014. Furthermore, this incision did not affect the results of the coughing exercise after surgery, which is beneficial for early rehabilitation.…”

Section: Discussionsupporting

confidence: 50%

Mitral Valve Surgery via a Right Infra-axillary Thoracotomy in High-Risk Reoperative Patients

Cao

Zhou

Xue

et al. 2020

HSF

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Background: A right infra-axillary thoracotomy can offer excellent exposure of the mitral valve. This study evaluated this incision for high-risk patients undergoing redo mitral valve procedures. Methods: Of a series of 189 patients who had redo mitral valve surgery, 32 were reoperated via vertical infra-axillary thoracotomy based on previous aortic valve replacement, dense adhesion, location of patent bypass grafts, and peripheral vascular disease. Results: Sternotomy was avoided in all cases. The mitral valve was replaced in 22 patients and repaired in 10 patients; left atrial folding was performed in 6 patients. All patients had uneventful outcomes and normal valve function during follow-up. Conclusions: Reoperative mitral valve surgeries can be performed safely using right infra-axillary thoracotomy in certain patients. The procedure offers excellent exposure of the mitral valve and minimizes the need for cardiac dissection, thus reducing injury risk. Avoiding a high risk of resternotomy increases patient comfort and safety.

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“…It usually leaves a big scar and an awkward appearance. The incidence of wound infections and septic complications is minimal with a thoracotomy than with a median sternotomy; this virtually eliminates mediastinitis [16][17][18]. We believe that an almost obscure, small, lower anterolateral thoracotomy scar in the skin fold of breast is more cosmetic and patient friendly as it provides early and fast recovery, less ICU stay, and decreased chances of mediastinitis, as compared with sternal incision.…”

Section: Discussionmentioning

confidence: 99%

Repair of ventricular septal defect through anterolateral thoracotomy with central cannulation: our experience

Dixit

Sharma

Suthar

et al. 2020

Indian J Thorac Cardiovasc Surg

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Background At present thoracotomy with femoro-femoral bypass is an established approach for minimally invasive open heart surgeries, but thoracotomy with conventional cannulation is yet to be established. We performed 54 cases of ventricular septal defect (VSD) closure via anterolateral thoracotomy approach with central cannulation. Here we are describing our results and experience of VSD closure via anterolateral thoracotomy approach. Aim and objective The aim of our study was to evaluate early outcomes of VSD repair via anterolateral thoracotomy with central cannulation. Methods This is a retrospective, observational, descriptive type of study. Fifty four patients (31 males, 23 females) underwent VSD repair from November 2016 to November 2018 via anterolateral thoracotomy with age ranges from 3 to 22 years (mean age 10.57 + 8.88 years). Mean body weight was 22.29 + 13.44 kg (range 10 to 48 kg). The VSD was perimembranous in 47 patients, subpulmonic in 2, muscular in 2, and inlet in 3 patients. Results There was no operative or late mortality. The mean incision length was 7.16 ± 02.08 cm (range, 5 cm to 9 cm). Average duration of cardiopulmonary bypass (CPB) was 61.72 ± 14.20 min (range, 48-78 min), and aortic cross-clamp time was 38.51 ± 13.08 min (range, 26-56 min). The average postoperative intensive care unit (ICU) stay was 1.83 ± 1.32 days (range, 1-3 days), and hospital stay was 4.92 ± 1.82 days (range, 4-7 days). Conclusion Anterolateral thoracotomy with conventional central cannulation can be a safe alternative to median sternotomy with superior cosmetic results for the repair of VSDs.

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Comparison between minimal right vertical infra-axillary thoracotomy and standard median sternotomy for repair of atrial septal defects

Abstract: Minimal right vertical infra-axillary thoracotomy can be performed with favorable cosmetic and clinical results for atrial septal defects closure. Infra-axillary thoracotomy provides a good alternative to standard median sternotomy for patients with atrial septal defects.

Cited by 21 publications

References 12 publications

Early- and Long-term Outcomes of Cardiovascular Surgery via Minimal Right Vertical Infra-axillary Thoracotomy: A 15-year Study of 1,126 Patients

Early- and Long-term Outcomes of Cardiovascular Surgery via Minimal Right Vertical Infra-axillary Thoracotomy: A 15-year Study of 1,126 Patients

Mitral Valve Surgery via a Right Infra-axillary Thoracotomy in High-Risk Reoperative Patients

Repair of ventricular septal defect through anterolateral thoracotomy with central cannulation: our experience

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