title: Right Anterolateral Thoracotomy in the Repair of Atrial Septal Defect: Effect on Breast Development.
abstract: OBJECTIVE
  The aim of this study was to assess the cosmetic results and the impact on the breast development of a right anterolateral thoracotomy (RALT) in pre-pubertal children who underwent RALT for correction of atrial septal defects.
  
  
  METHODS
  From December 2002 to July 2010, 25 female patients with a mean age of 8.5 ± 1.3 years underwent repair of atrial septal defects with a right anterolateral thoracotomy. Breast symmetry was described by a clinical index. The degree of scoliosis was measured by clinical examination. The subjective evaluation in breast asymetry, size, and shape was assessed by a survey obtained by the patients.
  
  
  RESULTS
  There was no intraoperative or postoperative complication or late mortality in the thoracotomy approach or in the long-term follow-up (7.5 ± 2.2 years). According to the survey, breast asymmetry and differences between both breast size or shape were found in 15 (60%) and seven (28%) patients, respectively. One patient (4%) complained of a keloid scar. Mild sensitive skin deficit in the mammary area was determined in four patients (16%). According to the objective assessment, breast asymmetry was found 12 patients (48%) with index 1 and 13 patients (52%) with index 2.
  
  
  CONCLUSIONS
  Although it is safe, the RALT is associated with the potential to effect unilateral breast development.
authors.affiliation: Department of Cardiovascular Surgery, Medical Faculty of Ege University, Izmir, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Isik
authors.affiliation: Department of Cardiovascular Surgery, Medical Faculty of Ege University, Izmir, Turkey.
authors.forename: Mehmet F
authors.initials: MF
authors.lastname: Ayik
authors.affiliation: Department of Cardiovascular Surgery, Medical Faculty of Ege University, Izmir, Turkey.
authors.forename: Muhammet
authors.initials: M
authors.lastname: Akyuz
authors.affiliation: Department of Cardiovascular Surgery, Medical Faculty of Ege University, Izmir, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Daylan
authors.affiliation: Department of Cardiovascular Surgery, Medical Faculty of Ege University, Izmir, Turkey.
authors.forename: Yuksel
authors.initials: Y
authors.lastname: Atay
mesh_terms: D001940:Breast / Q000002:abnormalities* / Q000254:growth & development* / Q000473:pathology; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006801:Humans; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires; D013908:Thoracotomy / Q000009:adverse effects* / Q000379:methods*; D013997:Time Factors