title: Cosmetic approach for correction of simple congenital heart defects in female patients.
abstract: OBJECTIVE
  Much more concern is recently paid to the cosmetics when simple congenital heart defect is repaired. Here we present the reversed U-shaped skin incision with lower partial sternotomy for juvenile or adult female patients.
  
  
  METHODS
  Four patients with atrial septal defect (ASD) and one patient with ventricular septal defect underwent the operation with this method. Patients' ages ranged from 5 to 46 years old.
  
  
  RESULTS
  Postoperative recovery in all cases was uneventful. Only the middle portion of the operative scar was visible when the breast was well developed. The scar was completely covered by the brassiere. A numbness of the upper medial portion of the left breast was recognized in one initial patient, who underwent ASD closure and concomitant right-side Maze procedure, necessitating a wider dissection than that used for other patients.
  
  
  CONCLUSIONS
  A reversed U-shaped skin incision with a lower sternotomy could provide relatively comfortable operative fields for cardiac surgeons, and be cosmetically appealing to female patients who require a repair of simple congenital heart defect.
authors.affiliation: Department of Cardiovascular Surgery, Iwakuni National Hospital, Iwakuni, Yamaguchi, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Murakami
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kuinose
authors.forename: Zen-ichi
authors.initials: Z
authors.lastname: Masuda
authors.forename: Eishun
authors.initials: E
authors.lastname: Shishido
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tanemoto
mesh_terms: D000293:Adolescent; D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004954:Esthetics; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D016896:Treatment Outcome