A Clinical Comparative Study Of Right Anterolateral Minithoracotomy And Conventional Median Sternotomy Incision In The Repair Of Atrial Septal Defect

Objective:To compare the effect of right anterolateral minithoracotomy andconventional median sternotomy incision in the atrial septal defect repair.Methods: A retrospective study was carried out at our hospital from May2012to Jan．2014．62patients with atrial septal defect (ASD) were submitted to surgicaltreatment. In this study,32(51.6%) patients underwent surgical repair of the atrialseptal defects through right anterolateral minithoractomy.10patients of them weremerged with moderate to severe pulmonary hypertension（PH）, and three cases ofthem were duing to partial anomalous pulmonary venous （PAPVR） While30(48.4%)patients underwent surgical repair of the atrial septal defects throughconventional median stemotomy with the heartbeat arrested， and complication ofmoderate to severe pulmonary hypertension in11cases，partial anomalous pulmonaryvenous drainage in2cases. Comparisons were performed between the2groups interms of cardiopulmonary bypass (CPB) time (min), ICU intensive care time (h),postoperative ventilator breathing time (h), postoperative hospital stay (d),postoperative drainage volume (ml), incision length (cm) and healing status indicator.Results: There was no operative mortality in the2groups． In the formergroup(small incision group), the postoparative mechanical ventilation time(6.5±2.5h)，postoperative drainage volume （227.3±122.6ml），intensive care time(16.1±7.3h),postoperative hospital stay（7.5±1.5d）and skin incision length（6.9±0.9cm）, were allsignificantly less than those of the latter group (conventional group) of patients，whose CPB time was（51±3.8min),postoperative mechanical ventilation time(7.8±3.6h)，postoperative drainage volune(508.0±135.5ml)，intensive care time (28.0±12.1h), and skin incision length (15.5±1.9cm)． P <0.05; The CPB time did not differsignificantly between the2groups61.7±18.6min vs51±3.8min, P>0.05． Partialincision of2patients in the latter group was liquefied and the healing of wound wasdelayed. In both groups, there were no air embolism, pneumothorax and otherrelated complications.Conclusion: A right anterolateral small cut Beating Heart atrial septal defectrepair in the treatment of atrial septal defects is a safe， effective and simpletechnique,and ensures minimal surgical invasion with shorter postoperative hospitalstay， faster recovery， less bleeding， more beautiful． Minithoraeotumy can berecommended as the standard method for the correction of atrial septal defects，especially in female patients.