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Right Vertical Axillary Incision For Ventricular Septal Defect: A Propensity Score Matched Study
Xicheng Deng, Yunfei Tian, Debin Zeng, Xiaohui Yang, Lijuan Liu, Guihong Yang, Jiayi Lin;
Hunan Children’s Hospital, Changsha, China
BACKGROUND: This study aimed to retrospectively analyze the therapeutic effect of direct view repair of ventricular septal defect (VSD) in infants using a right axillary vertical minimal incision approach.
METHODS:From January 2021 to May 2023, infants undergoing direct view VSD repair in our department were selected for this propensity score matched study. Patients who underwent surgery through a right axillary vertical minimal incision were assigned to the minimal incision group, and propensity score matching was used to match them 1:1 with patients undergoing median sternotomy (the median sternotomy group) based on age and weight. Surgical outcomes were compared between the two groups to evaluate the efficacy and safety of the minimal incision approach.
RESULTS:The median incision length was significantly shorter in the minimal incision group (5 cm, IQR 4-5 cm) compared to the median sternotomy group (P<0.001). The minimal incision group also had significantly less median drainage volume at 12 hours post-operation (55 ml, IQR 45-70 ml) versus the median sternotomy group (P=0.044). No significant between-group differences were observed in operation time, aortic cross-clamping time, ICU length of stay, total hospital length of stay, early postoperative oxygenation index, chest X-ray findings, or postoperative ECG abnormalities.
CONCLUSIONS:VSD repair through a right axillary vertical minimal incision is a safe and effective surgical technique, significantly reducing surgical trauma and providing superior cosmetic results compared to median sternotomy. This approach appears to be well accepted by families and warrants further clinical application.
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