COMPARATIVE ANALYSIS OF THE CLINICAL RESULTS OF PATIENTS WITH ASD OPERATED VIA RIGHT ANTERIOR MINITHORACOTOMY AND MEDIAN STERNOTOMY.

Abstract

Median sternotomy has been the conventional approach for correction of atrial septal defect despite poor cosmetic results at times. Right anterior minithoracotomy was, therefore, assessed as an alternative procedure with a better cosmetic outcome.

Material and methods: from April 2008 through February 2017 102 patients underwent correction of atrial septal defect with the use of normothermic perfusion on a beating heart through right anterior minithoracotomy involving a short incision through the fourth intercostals space and the direct cannulation. The 75 were female and 27 male end the averaging age 19,2±2,0 years. The corrected defects included atrial septal defect type II, atrial septal defect with short aortic edge, atrial septal defect with short inferior edge, atrial septal defect with short superior edge, sinus venosus superior type atrial septal defect and sinus venosus inferior type atrial septal defect. The length of the skin incision varied from 4 to 10 cm, depending on the age of the patient.

Results: There was no operative or late mortality or major morbidity. The mean cardiopulmonary bypass time was 19±4 minutes, the duration of mechanical ventilation after surgery in patients was 2,4±0,9 hours. Cosmetic result was very satisfactory in all patients.

Conclusions: The right anterior minithoracotomy incision is a safe and effective alternative to a median sternotomy for correction of atrial septal defect. Cosmetic results are highly satisfactory.