@Article{schd.2026.077974,
AUTHOR = {Xuming Mo, Taibing Fan, Zhongdong Hua, Christoph Haller, Shinichiro Oda, Shuhua Luo, Weijie Liang, Yuzhong Yang, Huaipu Liu, Nianguo Dong, Shoujun Li, Xinxin Chen, Jimei Chen, Hao Zhang, Qiang Shu, Haibo Zhang, Quansheng Xing, Jinghao Zheng, Xiaofeng Li, Teng Ming, Qi An, Ping Wen, Qiang Wang, Jirong Qi, Huiwen Chen, Shusheng Wen, Rui Chen, Ming Ye, Keming Yang, Minhua Fang, Caixia Liu, Ke Lin, Zhongshi Wu, Xiangming Fan, Zhengxia Pan, Yiqun Ding, Ming’an Pi, Xin Li, Yong Zou, Shuguang Tao, Renwei Chen, Li Ma, Libing Zhang, Tao You, Dongshan Liao, Cheng Zhou, Hongxin Li, Gengxu Zhou, Chunhu Gu, Zhiqiang Li, Yonggang Li, Hui Zhang, Xiaomin He, Yanan Lu, Haifa Hong, Benqing Zhang, Li Gong, Jiafeng Qi, Song Bai, Yuhang Liu, Tianli Zhao, Cardiothoracic Surgery Group, Pediatric Surgery Branch of Chinese Medical Doctor Association, Cardiac Surgery Group, Pediatric Surgery Branch of Chinese Medical Association, the Asian Association for Pediatric and Congenital Heart Surgery},
TITLE = {Expert Consensus on Right Axillary Incision Approach for Open-Heart Surgery in Congenital Heart Disease},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {21},
YEAR = {2026},
NUMBER = {1},
PAGES = {--},
URL = {http://www.techscience.com/schd/v21n1/66831},
ISSN = {3071-1738},
ABSTRACT = {Congenital heart disease (CHD) is a common birth defect in children, and surgical intervention is the primary treatment. The traditional standard median sternotomy (MS) has drawbacks such as significant trauma and obvious scarring. The right axillary incision (RAI) has gradually become a conventional approach due to its advantages of preserving thoracic cage integrity, small incision size, rapid recovery, and hidden scarring. However, there is currently a lack of relevant guidelines and consensus for its application. This consensus adopts the international Delphi process, systematically searching domestic and foreign literature on CHD from 1982 to 2024. It uses the GRADE system for evidence grading and, through multidisciplinary expert discussions, clarifies the applicable CHD types, surgical techniques, establishment of extracorporeal circulation, organ protection strategies, management of special disease types, and approaches to common complications of RAI. Results show that RAI is strongly recommended for most simple congenital heart diseases (CHDs) (e.g., simple ventricular septal defect, atrial septal defect), weakly recommended for some complex CHDs (e.g., mild tetralogy of Fallot), and not recommended for complex CHDs such as transposition of the great arteries or in children with severe right thoracic deformity. Additionally, it standardizes key operational parameters: weight (5–30 kg as optimal), age (6 months–6 years as preferred), incision location, extracorporeal circulation cannulation, and organ protection measures. This consensus provides an evidence-based basis for standardizing the clinical application of RAI in open-heart surgery for CHD, ensuring surgical safety and efficacy.},
DOI = {10.32604/schd.2026.077974}
}