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Tocharoenchok T, Haller C. Superior cavopulmonary shunt via right vertical axillary mini-thoracotomy. Eur J Cardiothorac Surg 2024; 65:ezae053. [PMID: 38400757 DOI: 10.1093/ejcts/ezae053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/18/2024] [Accepted: 02/21/2024] [Indexed: 02/26/2024] Open
Abstract
We present 2 cases of patients with univentricular heart physiology of different anatomic variants who successfully underwent minimally invasive bidirectional cavopulmonary anastomosis via the right vertical axillary mini-thoracotomy.
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Affiliation(s)
- Teerapong Tocharoenchok
- Division of Cardiovascular Surgery, The Labatt Family Heart Centre, The Hospital for Sick Children, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Christoph Haller
- Division of Cardiovascular Surgery, The Labatt Family Heart Centre, The Hospital for Sick Children, Department of Surgery, University of Toronto, Toronto, ON, Canada
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Lo Rito M, Brindicci YCM, Moscatiello M, Varrica A, Reali M, Saracino A, Chessa M, Aloisio T, Isgrò G, Giamberti A. Minimally Invasive Surgery for Simple Congenital Heart Defects: Preserving Aesthetics without Jeopardizing Patient Safety. J Cardiovasc Dev Dis 2023; 10:452. [PMID: 37998510 PMCID: PMC10672407 DOI: 10.3390/jcdd10110452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 11/25/2023] Open
Abstract
Minimally invasive surgeries for pediatric patients have been proposed for decades, with different approaches in mind. Minimal right axillary thoracotomy (MRAT), proposed two decades ago, allows the preservation of patients' safety alongside faster aesthetic and functional recovery. The MRAT did not become widely adopted due to the prejudice that to follow a minimally invasive approach, safety and efficacy must be compromised. With this study, we aim to compare MRAT to the standard median sternotomy approach with a focus on safety and clinical outcomes. Between January 2017 and April 2021, 216 patients diagnosed with ASD, pAVSD, or PAPVD underwent surgical repair with different approaches in the same period. MRAT was used for 78 patients, and median sternotomy was used for 138 patients. In this last group, standard median sternotomy (SMS) was used for 116 patients, while a minimal skin incision (SMS mini) was used for 22 patients. There were no major complications overall nor in each specific approach. MRAT enabled the successful repair of simple heart defects, providing similar post-operative and cardiological recovery. MRAT does not compromise patients' safety and does not prolong the duration of surgery once the learning curve is overcome, which is generally after 15-20 consecutive operations.
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Affiliation(s)
- Mauro Lo Rito
- Department of Congenital Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy; (Y.C.M.B.); (A.V.); (M.R.); (A.G.)
| | - Ylenia Claudia Maria Brindicci
- Department of Congenital Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy; (Y.C.M.B.); (A.V.); (M.R.); (A.G.)
| | - Mario Moscatiello
- Department of Congenital Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy; (Y.C.M.B.); (A.V.); (M.R.); (A.G.)
| | - Alessandro Varrica
- Department of Congenital Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy; (Y.C.M.B.); (A.V.); (M.R.); (A.G.)
| | - Matteo Reali
- Department of Congenital Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy; (Y.C.M.B.); (A.V.); (M.R.); (A.G.)
| | - Antonio Saracino
- Department of Pediatric and Adult Congenital Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy; (A.S.); (M.C.)
| | - Massimo Chessa
- Department of Pediatric and Adult Congenital Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy; (A.S.); (M.C.)
| | - Tommaso Aloisio
- Department of Cardiothoracic and Vascular Anesthesia and Intensive Care Unit (ICU), IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy; (T.A.); (G.I.)
| | - Giuseppe Isgrò
- Department of Cardiothoracic and Vascular Anesthesia and Intensive Care Unit (ICU), IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy; (T.A.); (G.I.)
| | - Alessandro Giamberti
- Department of Congenital Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy; (Y.C.M.B.); (A.V.); (M.R.); (A.G.)
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Impact of right anterolateral thoracotomy with a new approach on breast development: survey analysis of female cardiac surgery patients. Cardiol Young 2023; 33:271-279. [PMID: 35225197 DOI: 10.1017/s1047951122000506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Our aim was to present the effects of submammarian thoracotomy by our new approach to breast development in young female patients between 8 and 14 years old. METHODS Atrial septal defect closure was performed in 55 female patients between 8 and 14 years old at the time of operation between January 2010 and January 2018 by median sternotomy or right anterolateral thoracotomy. These patients were called for a follow-up visits, breast examination were performed, and a questionnaire of 10 questions was applied. RESULTS According to the answer given by the patients to the question of "how would you describe your scar" showed that the surgical method satisfies all patients cosmetically in study group. The overall satisfaction rate for the cosmetic results of operation was 100% versus 41.1%, respectively. The percentage of patients said no to the question "Do you experience lack of self-confidence related your scar" was significantly higher than the control group (p < 0.001). The percentage of those who said yes to the question "Would you like to be operated with the same approach if you will have surgery again?" in the study group was significantly higher than the control group (p = 0.002). CONCLUSIONS We consider that our procedure is safe and effective with improved cosmetic results compared to median sternotomy which also confers many advantages such as less trauma, less pain, faster recovery, and shorter hospital stay. This study presents one of the largest series of paediatric patients operated by submammarian thoracotomy.
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Yang X, Hu Y, Dong J, Huang P, Luo J, Yang G, Deng X. Rightvertical axillary incision for atrial septal defect: a propensity score matched study. J Cardiothorac Surg 2022; 17:256. [PMID: 36199116 PMCID: PMC9535985 DOI: 10.1186/s13019-022-01999-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 09/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background Atrial septal defect is one of the most common types of congenital heart disease. This study aims to explore the surgical and cosmetic effects of open-heart surgery with right vertical axillary incision for simple congenital heart disease in infants. Methods From June 2018 to October 2021, children who underwent direct surgery of atrial septal defect in our department were selected for a propensity score matched study. Those with direct surgery through the right vertical axillary incision were included in the right vertical axillary incision group. According to age and weight, propensity score matching method was employed to match children from the right vertical axillary incision group with those undergoing direct surgery through median sternotomy (median sternotomy group) at a 1:2 ratio. Surgery outcomes between two groups were compared to evaluate the effectiveness and safety of right vertical axillary incision group. Results The median incision length (median, [interquartile range]) in right vertical axillary incision group (4.8 cm, [4.0–5.0]) was shorter than that in median sternotomy group (p < 0.001). The median drainage volume of drainage tube of the right vertical axillary incision group (117.5 ml, [92.8,152.8]) was smaller than that of median sternotomy group (p = 0.021). While no residual bubbles cases in the left and right ventricles and outflow tract were present in the right vertical axillary incision group, 44% of residual air bubble rate in right ventricular outflow tract was detected in median sternotomy group (p = 0.001). Additional sedation and analgesia (p = 0.003), wound infection or poor healing (p = 0.047), thoracic deformity healing (p = 0.029) and appearance satisfaction questionnaire (p = 0.018) in the right vertical axillary incision group were better than those in the median sternotomy group. Conclusion Right axillary vertical incision can effectively reduce surgical trauma, accelerate postoperative rehabilitation. This surgical approach also provides better cosmetic effect, which is easily accepted by children’s families and worthy of further clinical application.
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Affiliation(s)
- Xiaohui Yang
- Heart Center, Hunan Children's Hospital, No. 86 Ziyuan Road, 410007, Changsha, China
| | - Yuan Hu
- Department of Echocardiography and Ultrasound, Hunan Children's Hospital, 410007, Changsha, China
| | - Jie Dong
- Pediatrics Research Institute of Hunan Province, Hunan Children's Hospital, Changsha, China
| | - Peng Huang
- Heart Center, Hunan Children's Hospital, No. 86 Ziyuan Road, 410007, Changsha, China
| | - Jinwen Luo
- Heart Center, Hunan Children's Hospital, No. 86 Ziyuan Road, 410007, Changsha, China
| | - Guangxian Yang
- Heart Center, Hunan Children's Hospital, No. 86 Ziyuan Road, 410007, Changsha, China
| | - Xicheng Deng
- Heart Center, Hunan Children's Hospital, No. 86 Ziyuan Road, 410007, Changsha, China.
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Abstract
OBJECTIVES The mini right axillary thoracotomy is an alternative surgical approach to repair certain congenital heart defects. Quality-of-life metrics and clinical outcomes in children undergoing either the right axillary approach or median sternotomy were compared. METHODS Patients undergoing either approach for the same defects between 2018 and 2020 were included. Demographic details, operative data, and outcomes were compared between both groups. An abbreviated quality of life questionnaire based on the Infant/Toddler/Child Health Questionnaires focused on the patient's global health, physical activity, and pain/discomfort was administered to all parents/guardians within two post-operative years. RESULTS Eighty-seven infants and children underwent surgical repair (right axillary thoracotomy, n = 54; sternotomy, n = 33) during the study period. There were no mortalities in either group. The right axillary thoracotomy group experienced significantly decreased red blood cell transfusion, intubation, intensive care, and hospital durations, and earlier chest tube removal. Up to 1 month, parents' perception of their child's degree and frequency of post-operative pain was significantly less after the right axillary thoracotomy approach. No difference was found in the patient's global health or physical activity limitations beyond a month between the two groups. CONCLUSIONS With the mini right axillary approach, surrogates of faster clinical recovery and hospital discharge were noted, with a significantly less perceived degree and frequency of post-operative pain initially, but without the quality of life differences at last follow-up. While providing obvious cosmetic advantages, the minimally invasive right axillary thoracotomy approach for the surgical repair of certain congenital heart lesions is a safe alternative to median sternotomy.
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Zhu J, Zhang Y, Bao C, Ding F, Mei J. Individualized strategy of minimally invasive cardiac surgery in congenital cardiac septal defects. J Cardiothorac Surg 2022; 17:5. [PMID: 35033146 PMCID: PMC8761281 DOI: 10.1186/s13019-022-01753-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 01/08/2022] [Indexed: 12/03/2022] Open
Abstract
Background Intracardiac septal defect is repaired using median sternotomy in most centers; however, there are several reports using minimally invasive surgery in both children and adults. This study summarized our strategy of minimally invasive therapy using various lateral mini-thoracotomies in patients with congenital septal defect. Methods In this study, 472 patients who underwent minimally invasive repair of intracardiac septal defects (atrial septal defect, (ASD), ventricular septal defect, (VSD), and atrioventricular septal defect, (AVSD)) from January 2012 to June 2020 were retrospectively reviewed. Those who underwent device closure were excluded. The minimally invasive strategy included three groups: the right sub-axillary vertical incision (RSAVI) group (N = 335, including192 ASDs, 135 VSDs and 8 AVSDs); the right anterolateral thoracotomy (RALT) group (N = 132, including 77 ASDs, 51 VSDs and 4 AVSDs); and the left anterolateral thoracotomy (LALT) group (N = 5, all subpulmonary VSDs). Results Concomitant surgeries included nine cases of right ventricular outflow tract obstruction relief, nine cases of mitral repairs and 37 cases of tricuspid repairs. There was one transition from thoracotomy to sternotomy. Three patients required second pump run for residual lesions (two residual VSD shunts and one mitral regurgitation). The age and body weight of the RSAVI group were significantly lower than those of the RALT and LALT groups (all P < 0.01). No postoperative death was observed. Postoperative complications included one case of chest exploration for bleeding, one case of reoperation due to patch dehiscence during the same admission, one case of transient neural dysfunction, three cases of diaphragmatic paresis and 13 cases of atelectasis. The median stay in the intensive care unit was two days, while the median postoperative hospitalization duration was six days. The echocardiography results before discharge indicated no significant residual lesions. No reoperation, no new onset of chest deformities and no sclerosis were observed during the follow-up. Conclusions Intracardiac septal defects can be safely and effectively repaired by minimally invasive surgery with good cosmetic results. RSAVI is suitable in infants and children, while RALT is more commonly used in adolescents and adults. LALT is an alternative incision to repair subpulmonary VSD.
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Affiliation(s)
- Jiaquan Zhu
- Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Yunjiao Zhang
- Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China.
| | - Chunrong Bao
- Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China.
| | - Fangbao Ding
- Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Ju Mei
- Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
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Watanabe N, Kovalenko O, Hapak A, Nasirov T. Neonatal right mini thoracotomy for repair of critical pulmonary stenosis. Asian Cardiovasc Thorac Ann 2021; 30:593-595. [PMID: 34225461 DOI: 10.1177/02184923211029391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Over the last few decades, due to evolving surgical techniques and medical management, there has been a significant decrease in the rate of mortality and complications for neonates born with critical pulmonary valve stenosis. Median sternotomy is the standard approach; however, this longitudinal midline incision is invasive and leaves a significant scar. A right mini thoracotomy approach to this surgical repair decreases recovery time and the chance of possible future psychological distress from a visible median sternotomy scar. This is the first article to describe a right mini thoracotomy approach for critical pulmonary stenosis during the neonatal period.
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Affiliation(s)
- Naruhito Watanabe
- Department of Pediatric Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Oleg Kovalenko
- Department of Pediatric Cardiology, Sutter Medical Center, Sacramento, CA, USA
| | - Ashley Hapak
- Department of Pediatric Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Teimour Nasirov
- Department of Pediatric Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, USA
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Bayya PR, Kottayil BP, Srimurugan B, Balachandran R, Jayashankar JP, Baquero L, Kumar RK. Transaxillary Approach for Surgical Repair of Simple Congenital Cardiac Lesions: Pitfalls, and Complications. World J Pediatr Congenit Heart Surg 2021; 12:337-343. [PMID: 33942688 DOI: 10.1177/2150135121989663] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND In the treatment of simple congenital cardiac lesions, percutaneous and cosmetic surgical approaches have steadily gained prominence. Surgically, right vertical axillary approach is sparsely used despite superior cosmesis and less pain and blood product usage. Knowledge of potential pitfalls could lead to its more widespread acceptance. METHODS We retrospectively analyzed perioperative outcomes of 104 consecutive patients who underwent surgery by this technique between mid-2016 and December 2019, including ostium secundum (67), sinus venosus (34), coronary sinus (1), and ostium primum (1) atrial septal defects and hemianomalous pulmonary venous connection (1). Perioperative variables, surgical times, complications, and follow-up data were analyzed. RESULTS Patient weight ranged from 6.8 to 41 kg. Incision length ranged from 4 to 6 cm. There was no mortality. All cannulation was central. Difficulty in cannulation (inferior vena cava) was seen in two patients. Morbidity included pneumothorax in 2 (1.9%) patients and subcutaneous emphysema necessitating prolonged intercostal drain retention in 20 (19.2%) patients. Surgical time increased linearly (r = 0.567; P < .001) with increasing patient weight but cardiopulmonary bypass (CPB) time remained unaffected. No chest deformities or paresthesia were noted on follow-up. Scar size decreased in some patients. CONCLUSIONS Right vertical axillary approach can be safely employed to treat simple congenital cardiac lesions with adequate awareness of potential pitfalls. Increasing patient weight increases the surgical time but does not affect CPB times. Incidence of pneumothorax and subcutaneous emphysema is similar to other thoracotomy approaches. It is cosmetically superior.
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Affiliation(s)
- Praveen Reddy Bayya
- Department of Cardiovascular and Thoracic Surgery, 29286Amrita Institute of Medical Sciences and Research Centre, Edappally, Kochi, India
| | - Brijesh Parayaru Kottayil
- Department of Cardiovascular and Thoracic Surgery, 29286Amrita Institute of Medical Sciences and Research Centre, Edappally, Kochi, India
| | - Balaji Srimurugan
- Department of Cardiovascular and Thoracic Surgery, 29286Amrita Institute of Medical Sciences and Research Centre, Edappally, Kochi, India
| | - Rakhi Balachandran
- Department of Cardiac Anaesthesia, 29286Amrita Institute of Medical Sciences and Research Centre, Edappally, Kochi, India
| | | | - Luis Baquero
- Heart Center, Red Cross Hospital, Chief of Cardiac Surgery, Lisbon, Portugal
| | - Raman Krishna Kumar
- Department of Pediatric Cardiology, 29286Amrita Institute of Medical Sciences and Research Centre, Edappally, Kochi, India
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An K, Li S, Yan J, Wang X, Hua Z. Minimal Right Vertical Infra-axillary Incision for Repair of Congenital Heart Defects. Ann Thorac Surg 2021; 113:896-902. [PMID: 33592183 DOI: 10.1016/j.athoracsur.2021.01.052] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/30/2020] [Accepted: 01/22/2021] [Indexed: 11/01/2022]
Abstract
BACKGROUND This study evaluated the surgical results of a diverse array of congenital heart defects through minimal right vertical infra-axillary incision (RVIAI). METHODS We performed a retrospective review of consecutive patients using minimal RVIAI for congenital heart defects between 2015 and 2019. The study included 1672 patients and minimal RVIAI was used for 13 primary procedures. The incision was 2.0 to 4.0 cm in all patients. RESULTS Median age was 2.3 years (range, 0.2-6.0 years) and median weight was 12.5 kg (range, 5.0-34.0 kg). There were no in-hospital deaths or conversions to median sternotomy. Five patients underwent early reoperations (0.3%; 3 had postoperative bleeding, 1 had coarctation of ascending aorta owing to cannulation, and 1 had a major residual shunt). Other postoperative complications included a trivial residual shunt in 16 patients (1.0%), pleural effusion in 3 (0.2%), and wound infection in 4 (0.2%). Median follow-up was 3.2 years (range, 0.2-4.9 years). There were no late deaths or late reoperations. During follow-up, no surgery-related thoracic deformity or breast asymmetry was noted. One patient had mild scoliosis. We randomly chose 100 patients to complete a questionnaire regarding patient satisfaction with minimal RVIAI. Results showed that all patients and their parents were satisfied with the cosmetic results. CONCLUSIONS Minimal RVIAI can be safely performed for a wide range of congenital heart defects with excellent cosmetic results. It may serve as a good alternative to median sternotomy, especially for young female patients.
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Affiliation(s)
- Kang An
- Pediatric Cardiac Surgery Center, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People's Republic of China
| | - Shoujun Li
- Pediatric Cardiac Surgery Center, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People's Republic of China
| | - Jun Yan
- Pediatric Cardiac Surgery Center, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People's Republic of China
| | - Xu Wang
- Pediatric Cardiac Surgery Center, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People's Republic of China
| | - Zhongdong Hua
- Pediatric Cardiac Surgery Center, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People's Republic of China.
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Aydin S, Temur B, Basgoze S, Guzelmeric F, Guvenc O, Erek E. Toward Routine Minimally Invasive Ventricular Septal Defect Closure Via Right Lateral Minithoracotomy. Front Pediatr 2021; 9:708203. [PMID: 34447728 PMCID: PMC8382850 DOI: 10.3389/fped.2021.708203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/09/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Improving the surgical results and recent advancement of transcatheter techniques for closure of ventricular septal defect (VSD) increased the demand for minimally invasive approaches. In this study, we analyzed the results of the patients who underwent VSD closure with right lateral minithoracotomy (RLMT). Methods: Between September 2014 and February 2021, 24 patients underwent minimally invasive VSD closure with RLMT. The median age of the patients was 16 months (range, 4-84 months). Fifteen patients (62.5%) were female. The median weight of the patients was 9.75 kg (range, 4.6-30 kg). The types of VSD were perimembranous in 19 patients, subaortic in three patients, inlet in one patient, and subpulmonic in one patient. Five patients had low-lying pulmonary stenosis in addition to VSD. Results: No perioperative death or major complication occurred during follow-up. All defects were repaired through RLMT. The median cardiopulmonary bypass time was 81 min (range, 44-163 min), and the aortic cross-clamp time was 65 min (range, 33-131 min). The median hospital stay was 6 days (range, 5-21 days). One patient had minimal (2 mm) residual left-to-right shunt. All families were satisfied with the cosmetic results during the follow-up. Conclusions: The RLMT method is a safe and effective alternative to standard median sternotomy for VSD closure and can be performed with favorable cosmetic and clinical results.
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Affiliation(s)
- Selim Aydin
- Department of Cardiovascular Surgery, Faculty of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Bahar Temur
- Department of Cardiovascular Surgery, Faculty of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Serdar Basgoze
- Department of Cardiovascular Surgery, Faculty of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Fusun Guzelmeric
- Department of Anesthesiology, Atakent Hospital, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Osman Guvenc
- Department of Pediatric Cardiolog, Atakent Hospital, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Ersin Erek
- Department of Cardiovascular Surgery, Faculty of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
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Heinisch PP, Bartkevics M, Beck MJ, Erdoes G, Glöckler M, Humpl T, Carrel T, Kadner A. Right Axillary Thoracotomy in Congenital Cardiac Surgery: Analysis of Percutaneous Cannulation. Ann Thorac Surg 2020; 112:2047-2053. [DOI: 10.1016/j.athoracsur.2020.10.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/16/2020] [Accepted: 10/05/2020] [Indexed: 10/23/2022]
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Del Nido PJ. Minimally Invasive Cardiac Surgical Procedures in Children. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2020; 15:95-98. [PMID: 32352909 DOI: 10.1177/1556984520914283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Pedro J Del Nido
- 1811 Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, MA, USA
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Affiliation(s)
- Ali Dodge-Khatami
- Division of Pediatric and Congenital Heart Surgery, Department of Pediatric Heart Surgery, McGovern Medical School, 6431 Fannin St, MSB 6.264, Houston, TX77030.
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