Document Detail

Ventricular septal defects closure using a minimal right vertical infraaxillary thoracotomy: seven-year experience in 274 patients.
MedLine Citation:
PMID:  20103340     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: From December 2001 to February 2008, right vertical infraaxillary thoracotomy (RVIAT) was used to perform ventricular septal defect (VSD) closure in selected patients. This retrospective study reviews our results and experiences. METHODS: The study included 274 patients (143 females, 131 males) undergoing VSD closure through a RVIAT approach. Patients were a mean age of 10.5 +/- 8.9 years (range, 0.5 to 43 years). Body weight was 37.8 +/- 12.5 kg (range, 8 to 72 kg). The VSD was subpulmonary in 14 patients and perimembranous in 260. RESULTS: No perioperative or late deaths occurred during the follow-up. Cardiac defects were corrected in all patients through RVIAT. The mean incision length was 7.2 +/- 2.9 cm (range, 4.1 to 8.9 cm). Cardiopulmonary bypass time was 61.6 +/- 27.8 minutes (range, 29 to 187 minutes), and aortic clamp time was 33.4 +/- 20.8 minutes (range, 5 to 139 minutes). The mean postoperative hospital stay was 4.9 +/- 2.6 days (range, 2 to 14 days). Postoperative echocardiograms revealed 3 patients with residual shunt with later catheter intervention. The cosmetic advantage of the RVIAT is the short incision under the armpit that is often invisible. All patients were satisfied with the cosmetic results during the follow-up. CONCLUSIONS: The RVIAT can be performed with favorable cosmetic and clinical results for VSD closure. It provides a good alternative to standard median sternotomy for VSD patients.
Qiang Wang; Qingguo Li; Jie Zhang; Zhong Wu; Qing Zhou; Dong-jin Wang
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  89     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-27     Completed Date:  2010-02-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  552-5     Citation Subset:  AIM; IM    
Copyright Information:
2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Department of Thoracic Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
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MeSH Terms
Axilla / surgery
Child, Preschool
Combined Modality Therapy
Heart Defects, Congenital / diagnosis,  surgery
Heart Septal Defects, Ventricular / diagnosis,  surgery*
Infant, Newborn
Retrospective Studies
Surgical Procedures, Minimally Invasive / methods*
Suture Techniques
Thoracotomy / methods*
Wound Healing / physiology
Young Adult

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