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Related Experiment Video

Updated: May 13, 2026

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
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Left axillary incision (minithoracotomy) for PDA division.

J Wada, H Ajiki, I Kitano

    The Annals of Thoracic Surgery
    |August 1, 1978
    PubMed
    Summary

    Division of patent ductus arteriosus (PDA) via axillary incision is a safe and feasible surgical approach, even for infants. This method minimizes scarring, addressing parental concerns for pediatric patients with PDA.

    Area of Science:

    • Cardiovascular Surgery
    • Pediatric Surgery

    Background:

    • Patent ductus arteriosus (PDA) is a common congenital heart defect.
    • Surgical scarring is a significant concern for parents of pediatric patients, particularly girls who represent the majority of PDA cases.
    • Traditional surgical approaches for PDA may leave noticeable scars.

    Purpose of the Study:

    • To evaluate the safety and feasibility of using a left axillary incision for patent ductus arteriosus (PDA) division.
    • To assess the outcomes of PDA division using a minimally invasive axillary approach in pediatric patients.

    Main Methods:

    • Retrospective review of 417 patent ductus arteriosus (PDA) operations performed between 1955 and 1975.
    • Analysis of the last 118 PDA divisions performed via a left axillary incision.

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  • Inclusion of data on patient age, sex, and operative outcomes.

    • Main Results:

    • The last 118 PDA divisions using the axillary approach had zero mortality.
    • Forty patients were under 2 years old, with 14 under 1 year old.
    • The study included a 3.5:1 female to male ratio, highlighting the relevance for cosmetic outcomes.

    Conclusions:

    • The axillary minithoracotomy is a safe and feasible surgical technique for PDA division.
    • This approach is effective even in very young and premature infants.
    • The axillary incision offers a cosmetic advantage, reducing parental concern over scarring.