Right Vertical Axillary Thoracotomy: Achieving Superior Results Without Adding Risk During Repair of a Wide Range of Congenital Cardiac Defects

Document Type : Original Article

Authors

1 Departments of Cardiothoracic Surgery, Faculty of Medicine, Beni Suef University, Egypt

2 Departments of Cardiothoracic Surgery, Faculty of Medicine, Benha University, Egypt

3 Departments of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Abstract

Background: Different incisions were tried to approach the heart rather than median sternotomy, targeting better cosmetic results without affecting the surgical outcome. However, most of these approaches added some risks that outweighed the desired benefits. We aimed to explain how vertical axillary thoracotomy could be an excellent alternative without adding surgical risk.
Patients and Methods: This Between May 2020 and January 2024, 118 patients with common congenital cardiac defects
were corrected through right vertical axillary thoracotomy. Sixty-eight patients underwent atrial septal defect closure,
repair of partial anomalous pulmonary venous drainage (17), ventricular septal defect closure (23), repair of partial
atrioventricular canal (four), mitral valve replacement (three), and subaortic membrane resection (three).
Results: There were 76 females and 42 males with a mean age of 6.5 years and a mean weight of 20.2kg. The mean
operative time was 227±42.5min, the mean cardiopulmonary bypass was 54.8±17.4min, and the mean aortic cross-clamp
time was 37.4±22.5min. There was no need to convert to sternotomy in any case. We have no 30-day mortality. The most
common complication was variable degrees of right lung atelectasis in 22(18.6%) cases. The mean intensive care unit
and hospital stay times were 2.8±2.3 and 6.3±3.8 days, respectively. The mean scar length was 5.8±0.6cm. Few wound
complications were observed during the follow-up period (6–24 months) with excellent cosmetic results.
Conclusion: In selected cases, the right vertical axillary thoracotomy is considered superior to median sternotomy
regarding cosmetic results without inferior surgical outcome.

Keywords

The Egyptian Journal of Surgery
Volume 44, Issue 2
April 2025
Pages 787-792

Files

Share

How to cite

Statistics