Comparison of incisions and outcomes for closure of ventricular septal defects.
BACKGROUND
Repair of ventricular septal defects (VSD) through a shorter right lateral thoracotomy has evolved for 10 years. However, outcomes of this surgery and patients' health-related quality of life have not been evaluated so far.


METHODS
Four hundred eighty-eight patients aged 6 to 15 years who had undergone repair of VSD through a right thoracotomy were surveyed (right group) and 185 patients of the same age were surveyed who had undergone the repair through a median sternotomy (median group). Cardiopulmonary bypass, aortic cross-clamping and mechanical ventilation time, amount of drainage, postoperative hospital stay, and in-hospital mortality and morbidity were measured as short-term outcomes. Symptoms, physical signs, ultrasonic cardiogram, chest film, and electrocardiogram were followed up as long-term outcomes; and the patients' TNO-AZL Children's Quality of Life (TACQOL) were studied to evaluate their health-related quality of life. The TNO-AZL Children's Quality of Life (TACQOL) questionnaire is a 56-item child quality of life questionnaire designed by the TNO Institute of Prevention and Health and the Leiden University Hospital (TNO-AZL).


RESULTS
Compared with the median group, the right group's short- and long-term outcomes were more satisfactory, with less drainage (106.71 +/- 85.20 mL versus 146.70 +/- 75.63 mL) and no pigeon chest (0 versus 3). The right group's TACQOL were higher than that of the median group in physical complaints (29.58 +/- 2.8 versus 28.07 +/- 2.95), motor functioning (31.23 +/- 1.09 versus 30.53 +/- 1.60), and cognitive functioning (29.93 +/- 3.22 versus 26.87 +/- 4.24).


CONCLUSIONS
Repair of VSD through a right thoracotomy can provide more satisfactory outcomes and better health-related quality of life.
D000293:Adolescent; D006348:Cardiac Surgical Procedures / Q000379:methods / Q000523:psychology; D002648:Child; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000175:diagnosis / Q000523:psychology / Q000601:surgery*; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D011336:Probability; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment; D013249:Sternum / Q000601:surgery*; D013536:Suture Techniques; D013908:Thoracotomy / Q000379:methods*; D016896:Treatment Outcome