Application of Right Subaxillary Small Incision to Open Heart Surgery / 中国微创外科杂志

ABSTRACT

Objective To summarize our experiences on open heart surgery through the right subaxillary small incision. Methods Between March 2001 and June 2008,612 patients with congenital heart diseases were treated by open surgery trough a right subaxillary small incision via hypothermic cardiopulmonary bypass. The incision was made from the posterior axillary line at the axilla to the middle axillary line a the fifth intercostal space (4-8 cm in length),and then the intercostal muscle was cut at the inferior edge of the fourth rib for the entrance into the chest cavity. In this series,165 patients had ASD,403 had VSD,35 had ASD complicated with VSD,3 showed PECD,and 6 were found as PAPVC. Results The mean cardiopulmonary bypass time was (25.0?5.5) min,402 of the patients (65.6%) need no blood transfusion. The mean hospital stay was (6.0?4.5) d,no patient died in hospital. The 420 patients were followed up for 5 to 80 months (mean 47 months). During the period,cardiac ultrasonography showed good outcomes in the patients. No complications or death were detected. Conclusions Right subaxillary small incision is a safe and minimally invasive method for the treatment of ASD and VSD with quick recovery,less hemorrhage,shorter hospital stay,less complications,and satisfying cosmetic outcomes.