Article Sidebar

PDF
Date Published: 26/08/2022
Abstract Views: 676
Views PDF: 160
DOI: https://doi.org/10.51298/vmj.v517i2.3271
Issue
Vol. 517 No. 2 (2022)
Section
Các bài báo
How to Cite
Trung Nam, N. ., & Lý Thịnh Trường, N. . (2022). OPEN HEART SURGERY USING THE VERTICAL RIGHT AXILLARY MINI-THORACOTOMY FOR TREATMENT OF LARGE VENTRICULAR SEPTAL DEFECT AT HANOI NATIONAL CHILDREN’S HOSPITAL. Vietnam Medical Journal, 517(2). https://doi.org/10.51298/vmj.v517i2.3271

OPEN HEART SURGERY USING THE VERTICAL RIGHT AXILLARY MINI-THORACOTOMY FOR TREATMENT OF LARGE VENTRICULAR SEPTAL DEFECT AT HANOI NATIONAL CHILDREN’S HOSPITAL

Nguyễn Trung Nam1, Nguyễn Lý Thịnh Trường2,
1 Thanh Hoa Pediatric Hospital
2 Children Heart Center, Vietnam National Children's Hospital

Main Article Content

Abstract

Objective: Evaluation of short-term outcomes for surgical treatment of large ventricular septal defect (VSD) using the vertical right axillary mini-thoracotomy at Hanoi National Children's Hospital. Methods: From January 2020 to December 2021, a total of 93 patients, diagnosed with a large VSD (diameter >6.5mm) undergoing VSD closure using the vertical right axillary mini-thoracotomy, were retrospective at Hanoi National Children’s Hospital.  Results: The median age at operation was 11.2 months (IQR, 6.4-25.4), and the median weight was 7.7kg (IQR, 6.4-11.5). There were 49 males and 44 females. The mean diameter of the VSD was 9,1 ± 1.8mm, mean pulmonary artery pressure was 38,2±13,4 mmHg (min:20-max:85). The mean length of incision was 5,6±0,5cm (min:5-max:7). The aortic cross-clamped time was 51,6±12,4minutes, bypass time was 68,9±15minutes and preparation time for bypass was 37,1 ±8,6minutes. There were 73 patients who have peri-membranous VSD, 19 patients have doubly committed VSD or muscular outlet VSD, and 1 patient who have an inlet VSD. The VSD closure was approached through the right atrium in 75 patients (80.6%) and through the pulmonary artery in 18 patients (19.4%). There was no early mortality, no late mortality, no reoperation, and no patient who required a permanent pacemaker due to complete atrioventricular block. There were 3 patients have wound infections, 3 patients have right upper lung atelectasis and 26 patients have a minor pneumothorax. The mean postoperative length of stay was 8 days (min:5-max:35). The echocardiography postoperative showed 8 patients who have a small residual VSD. However, after a mean follow-up of 13 ± 5,9months (min:6-max:30), there was no patient who revealed a residual VSD. All patients are stable with normal exercise activity and 97% of patients have normal development of the chest. Conclusions: The results of the vertical right axillary mini-thoracotomy for treatment of a large VSD at Hanoi National Children’s Hospital were safe, effective, and high-value of cosmetics. Alarger number of patients with a longer follow-up time are essential for evaluation of this surgical approach.

Article Details

Keywords

mini-invasive for open heart surgery, large ventricular septal defect, the vertical right axillary mini-thoracotomy

References

1. Prêtre R, Kadner A, Dave H, Dodge-Khatami A, Bettex D, Berger F. Right axillary incision: A cosmetically superior approach to repair a wide range of congenital cardiac defects. J Thorac Cardiovasc Surg. 2005 Aug;130(2):277–81.
2. Mishaly D, Ghosh P, Preisman S. Minimally Invasive Congenital Cardiac Surgery Through Right Anterior Minithoracotomy Approach. Ann Thorac Surg. 2008 Mar;85(3):831–5.
3. Yan L, Zhou ZC, Li HP, Lin M, Wang HT, Zhao ZW, et al. Right vertical infra-axillary mini-incision for repair of simple congenital heart defects: a matched-pair analysis. Eur J Cardiothorac Surg. 2013 Jan;43(1):136–41.
4. Heinisch PP, Wildbolz M, Beck MJ, Bartkevics M, Gahl B, Eberle B, et al. Vertical Right Axillary Mini-Thoracotomy for Correction of Ventricular Septal Defects and Complete Atrioventricular Septal Defects. Ann Thorac Surg. 2018 Oct;106(4):1220–7.
5. Bleiziffer S, Schreiber C, Burgkart R, Regenfelder F, Kostolny M, Libera P, et al. The influence of right anterolateral thoracotomy in prepubescent female patients on late breast development and on the incidence of scoliosis. J Thorac Cardiovasc Surg. 2004 May;127(5):1474–80.
6. Cherup LL, Siewers RD, Futrell JW. Breast and Pectoral Muscle Maldevelopment after Anterolateral and Posterolateral Thoracotomies in Children. :6.
7. Dave HH, Comber M, Solinger T, Bettex D, Dodge-Khatami A, Prêtre R. Mid-term results of right axillary incision for the repair of a wide range of congenital cardiac defects☆. Eur J Cardiothorac Surg. 2009 May;35(5):864–70.
8. An G, Zhang H, Zheng S, Wang W, Ma L. Mid-term Outcomes of Common Congenital Heart Defects Corrected Through a Right Subaxillary Thoracotomy. Heart Lung Circ. 2017 Apr;26(4):376–82.
9. An K, Li S, Yan J, Wang X, Hua Z. Minimal Right Vertical Infra-axillary Incision for Repair of Congenital Heart Defects. Ann Thorac Surg. 2022 Mar;113(3):896–902.