Abd Al-Fattah, H., Sharaa, M., Abd Al-Fattah, M. (2019). Surgical Outcomes of Right Anterolateral Minithoracotomy versus Median Sternotomy in Atrial Septal Defect. The Egyptian Journal of Hospital Medicine, 74(4), 735-743. doi: 10.21608/ejhm.2019.24083
Hossam ElSayed Abd Al-Fattah; Mohammed Eldesoky Sharaa; Mohammed Abd Al-Fattah. "Surgical Outcomes of Right Anterolateral Minithoracotomy versus Median Sternotomy in Atrial Septal Defect". The Egyptian Journal of Hospital Medicine, 74, 4, 2019, 735-743. doi: 10.21608/ejhm.2019.24083
Abd Al-Fattah, H., Sharaa, M., Abd Al-Fattah, M. (2019). 'Surgical Outcomes of Right Anterolateral Minithoracotomy versus Median Sternotomy in Atrial Septal Defect', The Egyptian Journal of Hospital Medicine, 74(4), pp. 735-743. doi: 10.21608/ejhm.2019.24083
Abd Al-Fattah, H., Sharaa, M., Abd Al-Fattah, M. Surgical Outcomes of Right Anterolateral Minithoracotomy versus Median Sternotomy in Atrial Septal Defect. The Egyptian Journal of Hospital Medicine, 2019; 74(4): 735-743. doi: 10.21608/ejhm.2019.24083
Surgical Outcomes of Right Anterolateral Minithoracotomy versus Median Sternotomy in Atrial Septal Defect
Department of Cardiothoracic Surgery, Faculty of Medicine, Al-Azhar University
Abstract
Background: the atrial septal defect repair has been traditionally approached through a median sternotomy. However, significant advances in surgical optics, instrumentation, tissue tele manipulation and perfusion technology have allowed for atrial septal defect repair to be performed by using progressively smaller incisions including the minithoracotomy. Aim of the study: this study aimed to compare the surgical outcome of right anterolateral minithoracotomy versus median sternotomy in atrial septal defect repair. Methods: this study was done in Department of Cardiothoracic Surgery at Elhussen Hospital, Al-Azhar University, after approval of the local ethical committee in the period between July 2017 till July 2018. 30 patients with ASD required ASD repair were included in this study for operative and short term postoperative results to evaluate the impact of two approaches of repair on quality of life of patients who survived the operation was studied. Results: The patients in both groups were similar in age preoperative comorbidities and ejection fraction but more female s were in Right anterolateral mini -thoracotomy group. There was a highly statistically significant prolonged pump-run time in the thoracotomy group than the sternotomy group with p-value ¼ 0.0 0 4. Interestingly, in the thoracotomy group, mechanical ventilation time (hours) was shorter with p-value ¼ 0.0 02. There were similar blood transfusion rate, chest tube drainage, intensive care unit stay and hospital length of stay. However, more wound infection was found in the sternotomy group which was statistically significant (p-value ¼ 0.035). There were no patients requiring conversion to full sternotomy, no residual defect across the atrial septum and all patients were alive on a month follow-up of the hospit al discharge. Conclusion: right antero-lateral mini-thoracotomy technique for atrial septal defect anomaly closure was safe and reliable technique as sternotomy incision. Apart from its restricted operating field and longer pump-run time, it kept the sternal integrity, it had better esthetic incision, it reduced wound infection and the need for analgesia. Moreover, it is associated with an early recovery and short ICU stay.
View on SCiNiTO
Top