Right Vertical Infra-Axillary Thoracotomy Approach in Simple Congenital Heart Diseases

Right thoracotomy approach has been gaining popularity in the repair of simple congenital heart diseases; especially, right vertical infra-axillary thoracotomy (RVIAT) provides a cosmetic benefit that is concealed and less evident but often requires peripheral cannulation. The surgical technique for RVIAT involved a 6-cm vertical incision in the right axillary fold, and cardiopulmonary bypass was established with ascending aorta and bicaval cannulations directly through the same surgical field. Intercostal block was routinely performed intra- and postoperatively to facilitate fast-track postoperative recovery. There is still a large potential to expand the selection criteria of RVIAT approach for further complicated diseases as a promising alternative to standard median sternotomy.