title: Experiences in surgical closure of atrial septal defect with anterior mini-thoracotomy approach.
abstract: BACKGROUND
  Anterior mini-thoracotomy approach is a good alternative to median sternotomy in Atrial Septal Defect (ASD) repair. Our purpose is to explain the details of our technique and peresent the results.
  
  
  METHODS
  Seventy five patients with ASD (52 female and 23 male) were operated with anterior mini-thoracotomy approach in our tertiary center between March 2012 and March 2014. The mean age was 14±10 ranged from 2 to 42 years. Outcomes were defined according to cardiopulmonary and aortic cross-clump time, intensive care unit stay time, morbidity, mortality, the size of incision, the amount of post-operative bleeding, need for blood transfusion and reoperation.
  
  
  RESULTS
  Mean Cardiopulmonary bypass time was 49.62 minutes (26 to 105 minutes) and mean aortic cross clamp time was 22.29±6.77 minutes (11 to 47 minutes). The mean amount of blood transfusion was 47.49± 62.22 mm (0 to 200 cc) and the mean chest tube drainage after surgery was 80.17 ±121.06 mm (0 to 600 cc). One patient re-operated for dehiscence of ASD surgical sutures and there was no reoperation for surgical bleeding or tamponade drainage in these patients. In 74 cases the defect was secundum type, in 2 patients it was sinus venosus type and in one with associated partial Anomalous repair.
  
  
  CONCLUSIONS
  Anterior thoracotomy approach is safe and may be the surgical technique of choice for secundum ASD repair in all age groups and we can utilize this technique also for more complicated kinds of surgery for instance, sinus venosus type ASD with or without Partial Anomalous Defect.
authors.affiliation: Interventional Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Bahador
authors.initials: B
authors.lastname: Baharestani
authors.affiliation: Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Shahabedin
authors.initials: S
authors.lastname: Rezaei
authors.affiliation: Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Farshad
authors.initials: F
authors.lastname: Jalili Shahdashti
authors.affiliation: Interventional Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Gholamreza
authors.initials: G
authors.lastname: Omrani
authors.affiliation: Cardiac Electrophysiology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Mona
authors.initials: M
authors.lastname: Heidarali
keywords: Atrial Septal Defects; Congenital Heart Defect; Minimally Invasive; Sternotomy; Surgical Procedures