Rightvertical axillary incision for atrial septal defect: a propensity score matched study

Area of Science:

• Pediatric Cardiac Surgery
• Congenital Heart Disease Treatment
• Minimally Invasive Cardiac Surgery

Background:

• Atrial septal defect (ASD) is a common congenital heart defect.
• Traditional open-heart surgery for ASD can have significant cosmetic and recovery implications for infants.
• Exploring alternative surgical approaches is crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate the surgical and cosmetic outcomes of open-heart surgery using a right vertical axillary incision in infants with simple congenital heart disease.
• To compare the effectiveness and safety of the right vertical axillary incision technique against traditional median sternotomy.

Main Methods:

• A propensity score-matched study comparing infants with ASD who underwent surgery via right vertical axillary incision versus median sternotomy.
• Matching was based on age and weight at a 1:2 ratio.
• Surgical outcomes, including incision length, drainage volume, residual air, and postoperative complications, were analyzed.

Main Results:

• The right vertical axillary incision group had significantly shorter incision lengths and lower drainage volumes.
• No residual air bubbles were detected in the right vertical axillary incision group, unlike the median sternotomy group.
• The right vertical axillary incision group showed improvements in additional sedation, wound healing, thoracic deformity, and patient satisfaction.

Conclusions:

• The right vertical axillary incision is an effective surgical approach for treating infant atrial septal defects.
• This technique reduces surgical trauma, accelerates postoperative rehabilitation, and provides superior cosmetic results.
• The approach is well-accepted by families and warrants further clinical investigation.