Short-Term Outcomes of Right Vertical Infra-Axillary Thoracotomy Approach for Partial Atrioventricular Septal Defect...

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Thoracic Surgery

Background:

• Partial atrioventricular septal defects (AVSD) are congenital heart conditions requiring surgical intervention.
• Minimally invasive surgical techniques are increasingly explored for improved patient outcomes.
• Evaluating the safety and efficacy of novel surgical approaches is crucial in pediatric cardiac surgery.

Purpose of the Study:

• To assess the postoperative outcomes of minimally invasive surgical repair for partial atrioventricular septal defects (AVSD).
• To evaluate the surgical safety and functional status of the left atrioventricular (AV) valve post-repair.
• To determine the effectiveness of the right vertical infra-axillary thoracotomy approach in partial AVSD repair.

Main Methods:

• Retrospective review of 32 patients undergoing minimally invasive repair of partial AVSD via right vertical infra-axillary thoracotomy.
• Echocardiography used to assess left AV valve function pre- and postoperatively.
• Fisher's exact test employed to compare pre- and 1-year postoperative left AV valve regurgitation.

Main Results:

• No mortality or surgical reintervention observed in a mean follow-up of 2.8 years.
• Significant improvement in left AV valve regurgitation, with 97% of patients showing mild or less regurgitation post-surgery (P < .01).
• No instances of conversion to median sternotomy, hemorrhage, pneumothorax, or diaphragm paralysis; one patient developed complete heart block.

Conclusions:

• Right vertical infra-axillary thoracotomy is a safe and effective approach for minimally invasive repair of partial AVSD.
• The short-term functional outcome of the left AV valve following this surgical technique is satisfactory.
• This minimally invasive strategy offers a viable alternative with good safety and functional results for partial AVSD.