Conventional On-pump Heart Surgery Through Right Vertical Infra-axillary Thoracotomy
Dongjin Wang, Qing Zhou, Jun Pan, Hailong Cao, Fudong Fan, Yunxing Xue.
Nanjing Drum Tower Hospital, Nanjing, China.
Background: Right vertical infra-axillary thoracotomy (RVIAT) for conventional on-pump heart surgery is a safe and effectful minimally invasive approach.To review the clinical experiences for conventional on-pump heart surgery through RVIAT in a single center. Methods: From January 2002 to December 2017, 2058 patients underwent heart surgery through RVIAT approach. 1347 patients were atrial septal defect or ventricle septal defect, 512 were mitral valve repair/replacement and 199 patients were aortic valve replacement. The arterial and venous cannulation are all through central approach (ascending aorta and vena cava), femoral cannulation is not necessary. The clinical characteristics and outcomes were reported. Results: The average age was 21.39±16.22 year, 64.6% were female. The length of skin incision was 5.5±1.2cm in child and 8.7±1.2cm in adult. 30-day mortality was 0.29%. No case should transfer to media thoracotomy. 23 patients underwent re-exploration because of postoperative bleeding. 14 case suffered surgical site infection. Conclusions: The minimally invasive approach through right vertical infra-axillary thoracotomy is an excellent choice for conventional on-pump heart surgery based on our huge number cases and long-term survival.
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