Minimally invasive right posterior minithoracotomy for open-heart procedures

A right posterior minithoracotomy was evaluated in 123 selected patients between November 2002 and August 2006. Their ages ranged from 1.5 to 32 years (mean, 7.8 years) and weights ranged from 12.3 to 61.6 kg (mean, 23.3 kg). Pathology included atrial septal defect in 81 (66%), ventricular septal defect in 16 (13%), and 24 other (mainly valve) defects. All patients had a strictly posterior right minithoracotomy through the 4(th) or 5(th) right intercostal space, with a 7-9-cm skin incision. There was no mortality or procedure-related morbidity. The mean cardiopulmonary bypass time was 68 min, ischemic time was 47 min, and 47 (38%) patients were extubated on the operating table. The mean hospital stay was 4.3 days and it was < 5 days in 108 (88%) patients. A cosmetically fine scar was achieved in all patients. The right posterior minithoracotomy is a safe, cosmetically superior, and cost-effective approach for selected open-heart procedures.