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Ann Thorac Surg 2008;85:199-203. doi:10.1016/j.athoracsur.2007.08.049
© 2008 The Society of Thoracic Surgeons
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Right arrow Congenital - acyanotic

Original Articles: Cardiovascular

Comparison of Incisions and Outcomes for Closure of Ventricular Septal Defects

Jianrong Li, PhD*, Yinglong Liu, MD, Cuntao Yu, MD, Bin Cui, MD, Ming Du, MD

Cardiovascular Institute and Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Laboratory of Congenital Heart Disease, Fuwai Cardiovascular Disease Hospital, Beijing, China

Accepted for publication August 22, 2007.

* Address correspondence to Dr Li, Laboratory of Congenital Heart Disease, Fuwai Cardiovascular Disease Hospital, 167 Beilishi St, Xicheng District, Beijing, 100037, China (Email: leejianrong{at}126.com).

Background: Repair of ventricular septal defects (VSD) through a shorter right lateral thoracotomy has evolved for 10 years. However, outcomes of this surgery and patients’ health-related quality of life have not been evaluated so far.

Methods: Four hundred eighty-eight patients aged 6 to 15 years who had undergone repair of VSD through a right thoracotomy were surveyed (right group) and 185 patients of the same age were surveyed who had undergone the repair through a median sternotomy (median group). Cardiopulmonary bypass, arotic cross-clamping and mechanical ventilation time, amount of drainage, postoperative hospital stay, and in-hospital mortality and morbidity were measured as short-term outcomes. Symptoms, physical signs, ultrasonic cardiogram, chest film, and electrocardiogram were followed up as long-term outcomes; and the patients’ TNO-AZL Children’s Quality of Life (TACQOL) were studied to evaluate their health-related quality of life. The TNO-AZL Children’s Quality of Life (TACQOL) questionnaire is a 56-item child quality of life questionnaire designed by the TNO Institute of Prevention and Health and the Leiden University Hospital (TNO-AZL).

Results: Compared with the median group, the right group’s short- and long-term outcomes were more satisfactory, with less drainage (106.71 ± 85.20 mL versus 146.70 ± 75.63 mL) and no pigeon chest (0 versus 3). The right group’s TACQOL were higher than that of the median group in physical complaints (29.58 ± 2.8 versus 28.07 ± 2.95), motor functioning (31.23 ± 1.09 versus 30.53 ± 1.60), and cognitive functioning (29.93 ± 3.22 versus 26.87 ± 4.24).

Conclusions: Repair of VSD through a right thoracotomy can provide more satisfactory outcomes and better health-related quality of life.






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