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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): Andreas Boening Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Cremer, J. T. Articles by Boening, A. Search for Related Content PubMed Articles by Cremer, J. T. Articles by Boening, A. Related Collections Related Article

Ann Thorac Surg 2001;72:1649
© 2001 The Society of Thoracic Surgeons

Invited commentary

^a Department of Cardiac and Vascular Surgery, University Hospital, Kiel Arnold Heller Strasse 7, 24105 Kiel, Germany

e-mail: jcremer{at}kielheart.uni-kiel.de

This study by Dr Abdel-Rahman and coworkers represents another contribution to a small number of articles dealing with limited access approaches to correct congenital heart defects with the aim of reducing surgical trauma and achieving more satisfying cosmetic results in young patients.

The authors claim excellent results using a right anterior minithoracotomy. For most of these patients, a thoracic cannulation technique was used for extracorporeal circulation. Special technical features include the use of a transthoracic aortic clamp in particular patients. The spectrum of procedures includes atrial spectal defect (ASD) closures and repair techniques for partial atrioventricular septal defects (AVSDs) and mitral valves through this approach. The majority of published articles focus on a significantly older patient group and deal primarily with just ASD closures.

The difference in the cosmetic effect between the described small right anterolateral thoracotomy and full sternotomy appears obvious, and was also described by Lancaster and associates [1]. On the other hand, the difference between a partial lower sternotomy and the described approach may be debatable. The length of the skin incision is very similar with equally satisfactory postoperative wound healing. However, the potential development of scoliosis after cardiac surgery in children approached through a thoracotomy and the existence of chronic pain syndrome may significantly limit the advantages of a right minithoracotomy. Aside from that, the group in Frankfurt is known for their access to robot technologies and may answer the question regarding which congenital corrective procedures are amenable to complete endoscopic repair.

References

1. Lancaster L.L., Mavroudis C., Rees A.H., Slater A.D., Ganzel B.L., Gray L.A. Surgical approach to atrial septal defect in the female. Am Surg 1990;56:218-221.[Medline]

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): Andreas Boening Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Cremer, J. T. Articles by Boening, A. Search for Related Content PubMed Articles by Cremer, J. T. Articles by Boening, A. Related Collections Related Article