title: Correction of simple congenital heart defects in children and adolescents through minithoracotomies.
abstract: OBJECTIVE
  To evaluate the repair of congenital heart defects through minithoracotomies.
  
  
  METHODS
  Between January 1998 and March 2005, 98 patients underwent minithoracotomies for simple congenital heart defect repairs at our institution. All patients were female between the ages of 14 months and 16 years (mean 4.6) with weights ranging from 8 to 58 Kg (mean 20). Diagnoses included 78 cases of atrial septal defects (ASD) (six with associated partial anomalous pulmonary venous drainage and four with pulmonary valve stenosis) and 20 cases of perimembranous ventricular septal defects (PVSD). All diagnoses were confirmed with an echocardiogram; therefore, cardiac catheterization was not required. A right submammary minithoracotomy was performed on 10 patients and a minithoracotomy with a partial median sternotomy was performed on 88 patients.
  
  
  RESULTS
  All defects were corrected successfully with satisfactory exposure. Cardiopulmonary bypass times ranged from 8 to 30 min (mean 10) and aortic clamping times ranged from 5 to 22 min (mean 12). All patients were extubated in the operating room and hospital stays ranged from 3 to 7 days (mean 5). There were no deaths during the operation or severe postoperative complications. No residual shunts were observed.
  
  
  CONCLUSIONS
  Our study demonstrated that the minithoracotomy is a safe effective and technically viable alternative to a median sternotomy to correct selected simple congenital heart defects. The advantages of this approach include less trauma, partial or complete preservation of sternum continuity and integrity, and elimination of postoperative deformities such as pectus carinatum. The cosmetic outcome was superior to a median sternotomy.
authors.affiliation: Hospital Santa Genoveva, Goiânia, GO, Brazil. wilson@cardiol.br
authors.forename: Wilson Luiz
authors.initials: WL
authors.lastname: da Silveira
authors.forename: Fabiana A Penachi
authors.initials: FA
authors.lastname: Bosco
authors.forename: Adélio Ferreira
authors.initials: AF
authors.lastname: Leite
authors.forename: Fernanda A Oliveira
authors.initials: FA
authors.lastname: Peixoto
authors.forename: Mirna
authors.initials: M
authors.lastname: de Sousa
authors.forename: Carlos César Elias
authors.initials: CC
authors.lastname: de Souza
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D006801:Humans; D007223:Infant; D012189:Retrospective Studies; D013908:Thoracotomy / Q000379:methods*; D016896:Treatment Outcome