Back to Annual Meeting Posters

OBJECTIVE: Minimally invasive approaches have become a feature of cardiac surgery. We compared the outcomes of atrial septal defect (ASD) closure in adults through either a right thoracotomy (RT) or a median sternotomy (MS).
METHODS: We compared the characteristics, perioperative factors and early outcomes of patients who underwent ASD closure to repair ostium secundum defects through either an RT (n = 11) or an MS (n = 7). A cardiopulmonary bypass (CPB) was established in the RT group via unilateral or bilateral femoral arterial cannulation. The ASD was closed directly or with an autologous pericardial patch in both groups.
RESULTS: Age, sex, body mass index and mean pulmonary arterial pressure did not significantly differ between the two groups, whereas preoperative Qp/Qs was significantly higher in the RT than in the MS group (2.95 ± 0.52 vs. 2.21 ± 0.75, p = 0.03). The perioperative durations of CPB and of cardiac arrest were longer in the RT than in the MS group (98 ± 32 vs. 45 ± 16 min, p = 0.001 and 42 ± 14 vs. 23 ± 9 min, p = 0.02, respectively), but the amount of intraoperative blood loss was lower in the RT than in the MS group (96 ± 53 vs. 209 ± 142 mL, p = 0.03). All patients underwent autologous blood transfusion. Early mortality rates, intubation time, length of ICU stay or hospitalization, and both total amount and duration of blood drainage did not significantly differ between the two groups. Laboratory findings revealed no significant differences in white blood cell counts and levels of C-reactive protein. Postoperative paroxysmal atrial fibrillation occurred in one and two patients in the RT and MS groups, respectively, but this was not a significant difference.
CONCLUSIONS: The outcomes of ASD closure through an RT were comparable with outcomes achieved with an MS, suggesting that the RT method is a safe and effective alternative to an MS for safe ASD closure in adults.