Right Vertical Infra-axillary Thoracotomy In Surgical Repair For Intra-cardiac Congenital Heart Defects Combined With Patent Ductus Arteriosus

Objective:To investigate effectiveness and safety of right vertical infra-axillary thoracotomy(RVIAT)in surgical repair for intracardiac anomalies combined with patent ductus arteriosus(PDA).Methods:We retrospectively analyzed the clinical data of 34 patients who underwent intracardiac correction of congenital heart defects and PDA ligation simultaneously via RVIAT in our hospital from August 2014 to August 2019.There were 25 males and 9 females included in the study,with an age range of 0.5-6.1 years.Results:The length of incision was 3.0(3.0,3.5)cm.The operation time lasted 110(90,121)min.The cardiopulmonary bypass time was 45.5(38.8,63.5)min and the aortic cross-clamp time was 22.5(14.8,34.8)min.The bleeding volume was 20.0(13.8,20.0)ml.ICU stay time was 17.0(5.5,22.3)h,post-operative mechanical ventilation time was 4.0(2.0,6.0)h,total in-hospital cost was 46391.4(38905.2,51423.9)RMB.There was no mortality or reoperation during perioperative and follow-up period.Within the median follow-up of 646 days,1 patient had minimal residual ventricular septal defect shunt while no new-onset scoliosis,funnel chest or pectus carinatum was detected.1 patient had minor discomfort at local surgical incision area.No bilateral mammary developmental asymmetry was observed in female patients during the follow-up period.All the patients’ parents or guardians were satisfied with the right vertical infra-axillary aesthetic skin incision.Conclusions:The minimally invasive repair for intracardiac heart defects combined with PDA via right vertical infra-axillary thoracotomy is a safe and effective method with minimal invasiveness and excellent cosmesis.