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Ann Thorac Surg 2003;75:1359-1360
© 2003 The Society of Thoracic Surgeons

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Correspondence

Alternative inferior vena cava cannulation facilitates ministernotomy procedures: Reply

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

To the Editor:

We wish to thank Dr Mohanakrishnan and associates for their interest in our recent article [1] and congratulate them on their establishment of a modified technique of inferior vena cava cannulation in the ministernotomy approach.

However, we wonder why Dr Mohanakrishnan and associates have changed their approach from right posterolateral thoracotomy to upper midline skin incision for closure of an atrial septal defect. Upper midline skin incision leaves an obvious and unsightly scar at the neck and the upper anterior chest wall. Patients after the operation are concerned with swimming, bathing, or wearing an open-necked shirt in public. Many surgeons have sought to limit the extent of the skin incision in the upper chest [2–4]. Inferior vena cava cannulation is not difficult in the lower ministernotomy approach.

As mentioned in our article, right posterolateral thoracotomy offers the benefit of a total absence of scarring in the anterior chest wall and of cosmetic disfigurement in the breast area [1]. We usually perform direct inferior vena cava cannulation with an angled cannula. This technique is quite easy and does not restrict the operative field.

References

1. Yoshimura N., Yamaguchi M., Oshima Y., Oka S., Ootaki Y., Yoshida M. Repair of atrial septal defect through a right posterolateral thoracotomy: a cosmetic approach to female patients. Ann Thorac Surg 2001;72:2103-2105.[Abstract/Free Full Text]
2. Komai H., Naito Y., Fujiwara K., et al. Lower mid-line skin incision and minimal sternotomy—a more cosmetic challenge for pediatric cardiac surgery. Cardiol Young 1996;6:76-79.
3. Barbero-Marcial M., Tanamati C., Jatene M.B., Atik E., Jatene A.D. Transxiphoid approach without median sternotomy for repair of atrial septal defects. Ann Thorac Surg 1998;65:771-774.[Abstract/Free Full Text]
4. Black M.D., Freedom R.M. Minimally invasive repair of atrial septal defects. Ann Thorac Surg 1998;65:765-767.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Masahiro Yamaguchi Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Yoshimura, N. Articles by Murakami, H. Search for Related Content PubMed Articles by Yoshimura, N. Articles by Murakami, H. Related Collections Congenital - acyanotic