Right axillary minithoracotomy: An alternative access to close an ASD
Hannah Widenka1, Alexander Kadner
1Center for Congenital Heart Disease, Swiss Cardiovascular Center, Inselspital, University Hospital Bern, Switzerland.
Multimedia Manual of Cardiothoracic Surgery : MMCTS
|May 21, 2021
Summary
A vertical right axillary thoracotomy offers a minimally invasive surgical option for congenital heart defect repair, providing faster recovery and hidden scars compared to traditional median sternotomy.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Minimally Invasive Procedures
Background:
- Median sternotomy is a standard approach for congenital heart defect repair.
- Axillary thoracotomy presents a muscle-sparing alternative, preserving thoracic structures.
- This technique is suitable for patients of all ages.
Discussion:
- The vertical right axillary thoracotomy allows direct access to right-sided heart structures via a small incision.
- Preservation of osseous thoracic structures is achieved by rib retraction, avoiding sternal division.
- Faster patient recovery and a cosmetically favorable scar are significant advantages.
Key Insights:
- Operative outcomes and long-term results of axillary thoracotomy are comparable to median sternotomy.
- No specialized equipment is required, utilizing established surgical techniques.
- The procedure is demonstrated using atrial septal defect closure as an example.
Outlook:
- Further adoption of axillary thoracotomy for various congenital heart defect repairs.
- Potential for reduced patient morbidity and improved cosmetic outcomes.
- Continued research validating long-term efficacy and expanding its application.
