Results of Vertical Infra-Axillary Thoracotomy for Total Repair of Tetralogy of Fallot.

Tien Anh Do, Bao Tuan Luong, Tran Thuy Nguyen, Phong Ba Nguyen, Huyen Nhu Thi Luong, Viet Bang Nguyen, Minh Ngoc Le, Duong Ha Thai Nguyen, Thanh Ngoc Le
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Abstract

Objective: To demonstrate the efficacy of minimally invasive surgery via a vertical infra-axillary incision for complete tetralogy of Fallot (TOF) correction.

Methods: In a study conducted from April to October 2023, 33 patients with TOF underwent total repair using this approach. On average, the patient age was 5.94 ± 2.68 months, weight was 6.49 ± 0.97 kg, and mean z-score index for the pulmonary valve annulus was -1.38 ± 0.92. Results also highlighted abnormal coronary artery pathways in 18.2% of cases, including 1 patient with dextrocardia and situs inversus.

Results: The average incision length was 4.01 ± 0.6 cm, with bypass and clamping times of 95.42 ± 33.19 min and 69.24 ± 28.15 min, respectively. Preservation of the pulmonary valve annulus was achieved in 67% of patients. No postoperative deaths occurred, and there were no significant ventilation differences between groups. After surgery, no severe pulmonary valve regurgitation was observed, with patients remaining in excellent condition throughout the 7-month follow-up. The pulmonary valve pressure gradient after the procedure was 23.97 ± 10.65 mm Hg, and no heart failure cases were reported per the Ross classification at the latest follow-up.

Conclusions: The vertical infra-axillary incision approach for total TOF repair is safe, effective, and cosmetically advantageous.

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垂直腋下胸廓切开术完全修复法洛氏四联症的结果
目的证明通过腋下垂直切口进行微创手术完全矫正法洛氏四联症(TOF)的疗效:在 2023 年 4 月至 10 月进行的一项研究中,33 名 TOF 患者采用这种方法接受了全修复手术。患者平均年龄为(5.94±2.68)个月,体重为(6.49±0.97)千克,肺动脉瓣环的平均 Z 评分指数为(-1.38±0.92)。结果还显示,18.2%的病例存在冠状动脉路径异常,其中包括1名患有右心室突出和坐位不正的患者:平均切口长度为(4.01 ± 0.6)厘米,分流和夹闭时间分别为(95.42 ± 33.19)分钟和(69.24 ± 28.15)分钟。67%的患者保留了肺动脉瓣环。术后无死亡病例,组间通气量无明显差异。术后未观察到严重的肺动脉瓣反流,患者在7个月的随访中状况良好。术后肺动脉瓣压力梯度为(23.97 ± 10.65)毫米汞柱,在最近的随访中,根据罗斯分类法,没有出现心力衰竭病例:结论:腋下垂直切口全 TOF 修补术安全、有效,且具有美观优势。
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来源期刊
CiteScore
2.00
自引率
6.70%
发文量
80
期刊介绍: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery is the first journal whose main mission is to disseminate information specifically about advances in technology and techniques that lead to less invasive treatment of cardiothoracic and vascular disease. It delivers cutting edge original research, reviews, essays, case reports, and editorials from the pioneers and experts in the field of minimally invasive cardiothoracic and vascular disease, including biomedical engineers. Also included are papers presented at the annual ISMICS meeting. Official Journal of the International Society for Minimally Invasive Cardiothoracic Surgery
期刊最新文献
Minimally Invasive Video-Assisted Surgery for Concomitant Ascending Aorta and Aortic Valve Replacement via Right Infra-Axillary Thoracotomy. Results of Vertical Infra-Axillary Thoracotomy for Total Repair of Tetralogy of Fallot. The 10 Commandments for the Ross Procedure. Dealing With the Aortic Annulus: Surgical Aortic Annulus Enlargement With a Ballon Catheter. A Risk Prediction Model for Prolonged Length of Stay After Minimally Invasive Valve Surgery.
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