Minimal right subaxillary thoracotomy combined with right atrial incision for subarterial ventricular septal defect closure in children
Wang Dong
Wu Yongtao
Jin Can
Liu Yuhua
Cheng Pei
Fan Xiangming
Liu Yinglong
Su Junwu
Abstract：Objective To summarize the clinical results of subarterial ventricular septal defect (VSD) correction through minimal right subaxillary thoracotomy combined with right atrial incision in children.Methods From January 2013 to December 2016,clinical data of 100 children with subarterial VSD who underwent surgical repair in Beijing Anzhen Hospital,Capital Medical University were retrospectively analyzed to compare three procedures including right subaxillary thoracotomy combined with right atrial incision (group R-A,40 cases),right subaxillary thoracotomy combined with longitudinal pulmonary artery incision (group R-P,40 cases) and median sternotomy combined with longitudinal pulmonary artery incision (group M-P,20 cases).The procedure through right atrial incision could fully expose subarterial VSD;tricuspid valve,supraventricular crest and right ventricular outflow septum approached to VSD were pulled to exposure the surgical field.Basic data,cardiopulmonary bypass time,aortic cross-clamping time,postoperative mechanical ventilation time,intensive care unit stay time,postoperative hospital stay time,complications and follow-up data were analyzed.Results Cardiopulmonary bypass time and aortic cross-clamping time in group R-A were significantly shorter than those in group R-P[(52 ± 11)min vs (58 ± 14)min,(30 ±9)min vs (36 ± 10)min] (both P ＜0.05).Postoperative mechanical ventilation time in group R-A and R-P were significantly shorter than that in group M-P[(10 ± 6),(9 ± 7) h vs (18 ± 9) h] (both P ＜ 0.05).The other indicators were similar among three groups (all P ＞ 0.05).All children were followed up 2 to 5 years with no late death and severe complication.Conclusion Repair of subarterial VSD through minimal right subaxillary thoracotomy combined with right atrial incision is safe and feasible for children.
Keywords：Congenital heart diseaseSubarterial ventricular septal defectMinimal right subaxillary thoracotomyRight atrial incision
Publication Date：2019-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：3( 855-857 )