[Correction of cardiac defects through a right minithoracotomy in children].
OBJECTIVE
To review the experience of correction of congenital cardiac defects through a right minithoracotomy.


METHODS
319 patients underwent correction of congenital heart malformations through right lateral thoracotomy under cardiopulmonary bypass. The average age was 3.44 +/- 1.59 years (range, 5 months-8 years). The average body weight was 13.66 - 3.98 kg (range, 6 - 26 kg). Cardiac defects repaired included atrial septal defect in 87 patients (1 patient associated with left superior vena cava (LSVC), 6 pulmonary stenosis, 5 partial anomalous pulmonary venous connection), ventricular septal defect in 200 (7 patients with coexisting patent ductus arteriosus, 7 mitral insufficiency, 3 LSVC, 11 right ventricular outflow tract obstruction), Fallot's Tetralogy in 19 (3 patients associated with LSVC, 1 single coronary malformation), partial endocardial cushion defect in 2 and other defects in 11. The mean cardiopulmonary bypass time was 56.07 +/- 24.90 min (range, 20 - 176 min) and the mean aortic crossclamping time was 32.97 +/- 20.38 min (range, 6 - 140 min). The average mechanical ventilation time after operation was 18.75 +/- 24.57 hr (range, 2 - 140.72 hr), and the mean postoperative hospital stay was 7.08 +/- 0.69 days (range, 7 - 17 days).


RESULTS
No operative mortality and severe postoperative complications were noted.


CONCLUSIONS
The right lateral thoracotomy is a safe and effective alternative to a median sternotomy for correction of cardiac defects. Advantages of this approach include less injury, maintaining the continuity and the integrity of the bony thorax, and preventing postoperative pigeon breast. The cosmetic result is superior to that of median sternotomy or bilateral submammary incision.
Liu
Y
Y
Department of Cardiac Surgery, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing 100037.
Zhang
H
H
Sun
H
H
Li
S
S
Shen
X
X
Yan
J
J
Yu
C
C
D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D004694:Endocardial Cushion Defects / Q000601:surgery; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006344:Heart Septal Defects, Atrial / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D013771:Tetralogy of Fallot / Q000601:surgery; D013908:Thoracotomy / Q000379:methods*; D016896:Treatment Outcome