TY  - EJOU
AU  - Said, Sameh M. 
AU  - Greathouse, Kristin C. 
AU  - McCarthy, Christina 
AU  - Khan, Megan 
AU  - Hagen, Molly 
AU  - Brown, Nicholas 
AU  - Kumar, Sacha 
AU  - Salem, Mahmoud I. 
AU  - Flaherty, James 
AU  - Essa, Yasin 

TI  - Right Axillary Thoracotomy <i>vs.</i> Median Sternotomy for Repair of Congenital Heart Defects in Infants and Children
T2  - Structural and Congenital Heart Disease

PY  - 2024
VL  - 19
IS  - 6
SN  - 3071-1738

AB  -  <b>Objective:</b> Vertical right thoracotomy (VRAT) has become an alternative to sternotomy for the repair of non-complex congenital heart defects in our infants and children. <b>Summary Background Data:</b> Limited data exists on the comparison of the two approaches. <b>Methods:</b> The present study consisted of two groups; Group I: (sternotomy; 33 patients) and Group II: (VRAT; 35 patients). We compared the two groups on operative data, hours of invasive lines, narcotics used, length of stay, and total variable cost of stay. <b>Results:</b> The most frequent procedures were atrial and ventricular septal defect closure (25 patients, 75.8% in Group I) and (14 patients, 40% in Group II). The average age and weight were 33.43 ± 53 months, and 14.7 ± 16.9 kg for Group I, and 75.3 ± 60.2 months and 24.9 ± 18 kg for Group II, respectively, (<i>p</i> < 0.001). We found no differences in aortic cross-clamp/bypass times between groups (<i>p</i> = 0.39 and 0.42, respectively). The use of narcotics was not significantly different between the two study groups (<i>p</i> = 0.37) as was the total variable cost (<i>p</i> = 0.115). Group II had a lower time without invasive lines (<i>p</i> < 0.001). In Group II the total length of stay was significantly less as well (<i>p</i> < 0.001). <b>Conclusions:</b> VRAT is a useful technique for repairing a wide range of heart defects and does not result in prolonged cardiopulmonary bypass or aortic cross-clamp times. Although total opioid use and total cost of stay are no different as with sternotomy, the shortened duration of invasive line use, and shorter length of stay make this approach worthy of consideration.
KW  - Minimally invasive cardiac surgery; congenital heart defects; right thoracotomy; vertical axillary right thoracotomy; axillary thoracotomy

DO  - 10.32604/chd.2025.061819