Safety and Efficacy of Right Axillary Thoracotomy for Repair of Congenital Heart Defects in Children

Authors

Sameh M. Said, Division of Pediatric Cardiovascular Surgery, Department of Surgery, Maria Fareri Children's Hospital, 8138Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
Kristin C. Greathouse, M Health Fairview Health System, Masonic Children's Hospital, Minneapolis, MN, USA.
Christina M. McCarthy, M Health Fairview Health System, Masonic Children's Hospital, Minneapolis, MN, USA.
Nicholas Brown, Division of Pediatric Critical Care Medicine, Department of Pediatrics, Masonic Children's Hospital, 5635University of Minnesota, Minneapolis, MN, USA.
Sacha Kumar, Division of Pediatric Critical Care Medicine, Department of Pediatrics, Masonic Children's Hospital, 5635University of Minnesota, Minneapolis, MN, USA.
Mahmoud I. Salem, Department of Cardiothoracic Surgery, 289164Port Said University, Port Said, Egypt.
Benjamin Kloesel, Department of Anesthesiology, 5635University of Minnesota, Minneapolis, MN, USA.
Sandeep Sainathan, Department of Cardiothoracic Surgery, 12235University of Miami, Miller School of Medicine, Miami, FL, USA.

Author Type(s)

Faculty

DOI

10.1177/21501351221127283

Journal Title

World Journal for Pediatric & Congenital Heart Surgery

First Page

47

Last Page

54

Document Type

Article

Publication Date

1-1-2023

Department

Surgery

Abstract

BACKGROUND: Minimally invasive repair of congenital heart defects in children has not gained wide popularity yet compared to minimally invasive approaches in adults. We sought to review our experience with this approach in children. METHODS: This study included a total of 37 children (24 girls, 64.9%) with a mean age of 6.5 ± 5.1 years, who underwent vertical axillary right minithoracotomy for repair of a variety of congenital heart defects between May 2020 and June 2022. RESULTS: The mean weight of these children was 25.66 ± 18.3 kg. Trisomy 21 syndrome was present in 3 patients (8.1%). The most common congenital heart defects that were repaired via this approach were atrial septal defects (secundum in 11 patients, 29.7%; primum in 5, 13.5%; and unroofed coronary sinus in 1, 2.7%). Twelve patients (32.4%) underwent repair of partial anomalous pulmonary venous connections with or without sinus venosus defects, while 4 patients (10.8%) underwent closure of membranous ventricular septal defects. Mitral valve repair, resection of cor triatriatum dexter, epicardial pacemaker placement, and myxoma resection occurred in 1 patient (2.7%) each. No early mortality or reoperations. All patients were extubated in the operating room, and the mean length of hospital stay was 3.3 ± 2.04 days. Follow-up was complete (mean 7 ± 5 months). No late mortality or reoperations. One patient required epicardial pacemaker placement due to sinus node dysfunction 5 months after surgery. CONCLUSIONS: Vertical axillary right thoracotomy is a cosmetically superior approach that is safe and effective for repair of a variety of congenital heart defects in children.

Recommended Citation

Said, S. M., Greathouse, K. C., McCarthy, C. M., Brown, N., Kumar, S., Salem, M. I., Kloesel, B., & Sainathan, S. (2023). Safety and Efficacy of Right Axillary Thoracotomy for Repair of Congenital Heart Defects in Children. World Journal for Pediatric & Congenital Heart Surgery, 14 (1), 47-54. https://doi.org/10.1177/21501351221127283