title: Comparison between minimal right vertical infra-axillary thoracotomy and standard median sternotomy for repair of atrial septal defects.
abstract: BACKGROUND
  The minimal right vertical infra-axillary thoracotomy could be a safe and cosmetic alternative to standard median sternotomy. This study reviews our results and experience with a minimal right vertical infra-axillary thoracotomy technique for the repair of atrial septal defects compared with standard median sternotomy.
  
  
  METHODS
  The study was designed as a retrospective, observational, and case-controlled study. Between May 2007 and November 2012, 26 patients underwent atrial septal defect closure with standard median sternotomy (Group 1). This group was compared with 21 patients who underwent repair of atrial septal defects using minimal right vertical infra-axillary thoracotomy (Group 2). Quantitative data were given as mean ± standard deviation, and qualitative values were expressed as percentages. In the comparison of the normal variables between the two groups, we used independent sample t test, and in the comparison of categorical variables between groups, Chi-square test was used.
  
  
  RESULTS
  The mean length of incision was significantly shorter in Group 2 than in Group 1 (p = 0.03). The time it took to establish cardiopulmonary bypass was longer in Group 2 (p = 0.04). There were no statistically significant differences in cardiopulmonary bypass time (p = 0.11), aortic cross-clamp time (p = 0.10), and total operation time (p = 0.10) between the two groups. Group 2 had less chest tube drainage (p = 0.04), less blood transfusion (p = 0.02), and shorter postoperative mechanical ventilation time (p = 0.09) than Group 1.
  
  
  CONCLUSIONS
  Minimal right vertical infra-axillary thoracotomy can be performed with favorable cosmetic and clinical results for atrial septal defects closure. Infra-axillary thoracotomy provides a good alternative to standard median sternotomy for patients with atrial septal defects.
authors.affiliation: Department of Cardiovascular Surgery, Faculty of Medicine, University of Cukurova, 01330, Sarıcam, Adana, Turkey. Electronic address: hafize101@yahoo.com.
authors.forename: Hafize
authors.initials: H
authors.lastname: Yaliniz
authors.affiliation: Department of Cardiovascular Surgery, Faculty of Medicine, University of Cukurova, 01330, Sarıcam, Adana, Turkey.
authors.forename: Mehmet Sah
authors.initials: MS
authors.lastname: Topcuoglu
authors.affiliation: Department of Cardiovascular Surgery, Faculty of Medicine, University of Cukurova, 01330, Sarıcam, Adana, Turkey.
authors.forename: Ugur
authors.initials: U
authors.lastname: Gocen
authors.affiliation: Department of Cardiovascular Surgery, Faculty of Medicine, University of Cukurova, 01330, Sarıcam, Adana, Turkey.
authors.forename: Atakan
authors.initials: A
authors.lastname: Atalay
authors.affiliation: Department of Cardiovascular Surgery, Faculty of Medicine, University of Cukurova, 01330, Sarıcam, Adana, Turkey.
authors.forename: Vecih
authors.initials: V
authors.lastname: Keklik
authors.affiliation: Department of Cardiovascular Surgery, Faculty of Medicine, University of Cukurova, 01330, Sarıcam, Adana, Turkey.
authors.forename: Yuksel
authors.initials: Y
authors.lastname: Basturk
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, University of Cukurova, 01330, Sarıcam, Adana, Turkey.
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Gunes
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, University of Cukurova, 01330, Sarıcam, Adana, Turkey.
authors.forename: Mediha
authors.initials: M
authors.lastname: Turktan
authors.affiliation: Department of Cardiovascular Surgery, Faculty of Medicine, University of Cukurova, 01330, Sarıcam, Adana, Turkey.
authors.forename: Orhan Kemal
authors.initials: OK
authors.lastname: Salih
mesh_terms: D000293:Adolescent; D000328:Adult; D001365:Axilla; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D056346:Sternotomy / Q000379:methods*; D013908:Thoracotomy / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: atrial septal defect; repair sternotomy; thoracotomy