Open Access iconOpen Access

ARTICLE

crossmark

Right Axillary Thoracotomy vs. Median Sternotomy for Repair of Congenital Heart Defects in Infants and Children

by Sameh M. Said1,2,*, Kristin C. Greathouse3, Christina McCarthy3, Megan Khan3, Molly Hagen4, Nicholas Brown5, Sacha Kumar5, Mahmoud I. Salem6, James Flaherty7, Yasin Essa1

1 Division of Pediatric and Adult Congenital Cardiac Surgery, Department of Surgery, Maria Fareri Children’s Hospital, Westchester Medical Center, New York Medical College, Valhalla, NY 10595, USA
2 Department of Cardiothoracic Surgery, Faculty of Medicine, Alexandria University, Alexandria, 21321, Egypt
3 Division of Pediatric Critical Care, M Health Fairview Health System, Masonic Children’s Hospital, Minneapolis, MN 55454, USA
4 Division of Pediatric Anesthesia, M Health Fairview Health System, Masonic Children’s Hospital, Minneapolis, MN 55454, USA
5 Division of Pediatric Critical Care Medicine, Department of Pediatrics, Masonic Children’s Hospital, University of Minnesota, Minneapolis, MN 55454, USA
6 Department of Cardiothoracic Surgery, Port Said University, Port Said, 42523, Egypt
7 Department of Anesthesiology, University of Minnesota, Minneapolis, MN 55454, USA

* Corresponding Author: Sameh M. Said. Email: email

Congenital Heart Disease 2024, 19(6), 563-575. https://doi.org/10.32604/chd.2025.061819

Abstract

Objective: Vertical right thoracotomy (VRAT) has become an alternative to sternotomy for the repair of non-complex congenital heart defects in our infants and children. Summary Background Data: Limited data exists on the comparison of the two approaches. Methods: 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. Results: 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, (p < 0.001). We found no differences in aortic cross-clamp/bypass times between groups (p = 0.39 and 0.42, respectively). The use of narcotics was not significantly different between the two study groups (p = 0.37) as was the total variable cost (p = 0.115). Group II had a lower time without invasive lines (p < 0.001). In Group II the total length of stay was significantly less as well (p < 0.001). Conclusions: 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.

Keywords


Cite This Article

APA Style
Said, S.M., Greathouse, K.C., McCarthy, C., Khan, M., Hagen, M. et al. (2024). Right axillary thoracotomy vs. median sternotomy for repair of congenital heart defects in infants and children. Congenital Heart Disease, 19(6), 563–575. https://doi.org/10.32604/chd.2025.061819
Vancouver Style
Said SM, Greathouse KC, McCarthy C, Khan M, Hagen M, Brown N, et al. Right axillary thoracotomy vs. median sternotomy for repair of congenital heart defects in infants and children. Congeni Heart Dis. 2024;19(6):563–575. https://doi.org/10.32604/chd.2025.061819
IEEE Style
S. M. Said et al., “Right Axillary Thoracotomy vs. Median Sternotomy for Repair of Congenital Heart Defects in Infants and Children,” Congeni. Heart Dis., vol. 19, no. 6, pp. 563–575, 2024. https://doi.org/10.32604/chd.2025.061819



cc Copyright © 2024 The Author(s). Published by Tech Science Press.
This work is licensed under a Creative Commons Attribution 4.0 International License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • 212

    View

  • 114

    Download

  • 0

    Like

Share Link