Open Access

ARTICLE

Right Axillary Thoracotomy for Anomalous Aortic Origin of a Coronary Artery in Children

Kuo Li^1,2, Yue Tang^1,2, Yonggang Li^1,2,*, Yuhao Wu^1,2,*
1 Department of Cardiothoracic Surgery, Children’s Hospital of Chongqing Medical University, Chongqing, 400014, China
2 Chongqing Key Laboratory of Structural Birth Defect and Reconstruction, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing, 400014, China
* Corresponding Author: Yonggang Li. Email: ; Yuhao Wu. Email:

Congenital Heart Disease https://doi.org/10.32604/chd.2026.076517

Received 21 November 2025; Accepted 05 January 2026; Published online 05 February 2026

Abstract

Background: There has been an increasing number of studies documenting the application of the right axillary thoracotomy (RAT) approach for the repair of congenital heart diseases. However, no research has reported the RAT approach in repairing the anomalous aortic origin of a coronary artery (AAOCA). This study aims to investigate the feasibility and safety of the RAT approach for repairing AAOCA in children. Methods: We performed a retrospective study at the Children’s Hospital of Chongqing Medical University between January 2024 and October 2025 to investigate the clinical outcomes of the RAT approach for repairing AAOCA in children. Results: A total of twelve patients with AAOCA were operated on via a RAT approach. Conventional unroofing was performed in eight cases, and a modified unroofing procedure was performed in four cases. Simultaneous repair of associated cardiac defects was conducted in eight cases. Postoperative pneumonia occurred in one patient. There were no early deaths during the hospitalization. The postoperative ostial diameter was significantly larger than the preoperative diameter (p = 0.0005). No patients were lost to follow-up, and aortic valve insufficiency was not observed during the follow-up. There were no late deaths reported following discharge, and ischemic signs were also not documented. Conclusions: Surgical repair via the RAT approach may serve as a safe and effective alternative for children with AAOCA. However, surgical strategies should be carefully determined based on preoperative assessment of the anomalous coronary arteries.

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Keywords

Anomalous aortic origin of a coronary artery; thoracotomy; children; congenital heart diseases

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