TY  - EJOU
AU  - Mo, Xuming 
AU  - Fan, Taibing 
AU  - Hua, Zhongdong 
AU  - Haller, Christoph 
AU  - Oda, Shinichiro 
AU  - Luo, Shuhua 
AU  - Liang, Weijie 
AU  - Yang, Yuzhong 
AU  - Liu, Huaipu 
AU  - Dong, Nianguo 
AU  - Li, Shoujun 
AU  - Chen, Xinxin 
AU  - Chen, Jimei 
AU  - Zhang, Hao 
AU  - Shu, Qiang 
AU  - Zhang, Haibo 
AU  - Xing, Quansheng 
AU  - Zheng, Jinghao 
AU  - Li, Xiaofeng 
AU  - Ming, Teng 
AU  - An, Qi 
AU  - Wen, Ping 
AU  - Wang, Qiang 
AU  - Qi, Jirong 
AU  - Chen, Huiwen 
AU  - Wen, Shusheng 
AU  - Chen, Rui 
AU  - Ye, Ming 
AU  - Yang, Keming 
AU  - Fang, Minhua 
AU  - Liu, Caixia 
AU  - Lin, Ke 
AU  - Wu, Zhongshi 
AU  - Fan, Xiangming 
AU  - Pan, Zhengxia 
AU  - Ding, Yiqun 
AU  - Pi, Ming’an 
AU  - Li, Xin 
AU  - Zou, Yong 
AU  - Tao, Shuguang 
AU  - Chen, Renwei 
AU  - Ma, Li 
AU  - Zhang, Libing 
AU  - You, Tao 
AU  - Liao, Dongshan 
AU  - Zhou, Cheng 
AU  - Li, Hongxin 
AU  - Zhou, Gengxu 
AU  - Gu, Chunhu 
AU  - Li, Zhiqiang 
AU  - Li, Yonggang 
AU  - Zhang, Hui 
AU  - He, Xiaomin 
AU  - Lu, Yanan 
AU  - Hong, Haifa 
AU  - Zhang, Benqing 
AU  - Gong, Li 
AU  - Qi, Jiafeng 
AU  - Bai, Song 
AU  - Liu, Yuhang 
AU  - Zhao, Tianli 
AU  - Group, Cardiothoracic Surgery 
AU  - Association, Pediatric Surgery Branch of Chinese Medical Doctor 
AU  - Group, Cardiac Surgery 
AU  - Association, Pediatric Surgery Branch of Chinese Medical 
AU  - Surgery, the Asian Association for Pediatric and Congenital Heart 

TI  - Expert Consensus on Right Axillary Incision Approach for Open-Heart Surgery in Congenital Heart Disease
T2  - Structural and Congenital Heart Disease

PY  - 2026
VL  - 21
IS  - 1
SN  - 3071-1738

AB  - 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.
KW  - Congenital heart disease; right axillary incision; open-heart surgery; expert consensus; extracorporeal circulation; perioperative management; GRADE system

DO  - 10.32604/schd.2026.077974