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Ann Thorac Surg 2001;72:2103-2105
© 2001 The Society of Thoracic Surgeons

Original article: cardiovascular

Repair of atrial septal defect through a right posterolateral thoracotomy: a cosmetic approach for female patients

Naoki Yoshimura, MD*a, Masahiro Yamaguchi, MDa, Yoshihiro Oshima, MDa, Shigeteru Oka, MDa, Yoshio Ootaki, MDa, Masahiro Yoshida, MDa

a Department of Cardiothoracic Surgery, Kobe Children’s Hospital, Kobe, Japan

Accepted for publication June 28, 2001.

* Address reprint requests to Dr Yoshimura, Department of Cardiothoracic Surgery, Kobe Children’s Hospital, 1-1-1, Takakura-dai, Suma-ku, Kobe 654-0081, Japan
e-mail: y-naoki{at}za2.so-net.ne.jp

Background. Because the operation for atrial septal defect is considered a low-risk procedure, the cosmetic result has become an important issue. Principally for cosmetic reasons, anterolateral thoracotomy is frequently used for closure of atrial septal defect in young female patients. However, in anterolateral thoracotomy, the skin incision frequently crosses the future breast line, which may cause breast and pectoral muscle maldevelopment.

Methods. We review the long-term results of a consecutive series of 126 patients in whom the atrial septal defect was closed through a right posterolateral thoracotomy. The mean age at operation was 7.1 years (range, 1 to 15 years), and the mean body weight was 23.9 kg (range, 6.9 to 56 kg). Defects repaired included 121 ostium secundum (central type), 3 sinus venosus, and 2 ostium secundum without inferior margin.

Results. The average cardiopulmonary bypass time was 65 minutes (range, 37 to 130 minutes), with an average fibrillation time of 41 minutes (range, 23 to 70 minutes). There was no operative or late mortality. A majority of patients were pleased with their cosmetic results. There were no other late complications.

Conclusions. Atrial septal defect can be safely repaired through a right posterolateral thoracotomy approach. This approach offers the benefit of a total absence of scarring and cosmetic disfigurement of the anterior chest wall.




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