Çocuklarda ve Genç Erişkinlerde Subaksiller Sağ Torakotomi Yaklaşımıyla (Bikini İnsizyonu) Minimal İnvaziv Atriyal Septal Defekt Onarımı

Abstract

Aim: The minimally invasive techniques in the treatment of congenital heart diseases have widely expanded recently both in terms of cosmetic results and patient comfort. In this report, we aimed to present our results of patients with the diagnosis of atrial septal defect and associated intracardiac pathologies who were operated through subaxillary mini thoracotomy.Materials and Methods: Seven patients who underwent subaxillary mini thoracotomy out of 53 patients with atrial septal defect that were operated with minimally invasive techniques in our clinic between 2009 and 2020 were identified. Six of the patients (85%) were girls and one was a boy (15%) and the mean age at operation was 8. 1  15.8 years.Results: Three patients had secundum atrial septal defect with a deficient septal rim; two patients had primum atrial septal defect, mitral cleft and mild mitral regurgitation and two patients had atrial septal defect, partial pulmonary venous return of the right pulmonary veins. All of the intracardiac pathologies were treated through right subaxillary mini thoracotomy. The mean cardiopulmonary bypass times and aortic cross clamp times were 71.5  19.2 and 44.4  22.1 minutes, respectively. Our patients were uneventfully discharged in 5.2  0.4 days. We did not encounter and morbidity or mortality in a mean follow up period of 4.4  3.1 years.Conclusion: The postoperative wound healing is faster and wound related complications are less frequently seen in patients undergoing cardiac surgery performed with minimally invasive techniques. The selection of subaxillary thoracotomy provides advantages both in terms of cosmetic aspects and breast development not being affected negatively.

Keywords

• congenital heart defect
• atrial septal defect
• partial anomalous pulmonary venous connection