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Right Vertical Infra-Axillary Thoracotomy Approach in Simple Congenital Heart Diseases

  • Yasuyuki Kobayashi
    Affiliations
    Department of Cardiovascular Surgery, Okayama University Hospital, Okayama, Japan

    Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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  • Shingo Kasahara
    Affiliations
    Department of Cardiovascular Surgery, Okayama University Hospital, Okayama, Japan

    Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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  • Yasuhiro Kotani
    Correspondence
    Address reprint requests to: Yasuhiro Kotani, 2-5-1 Shikatacho, Kitaku, Okayama, Japan 700-8558.
    Affiliations
    Department of Cardiovascular Surgery, Okayama University Hospital, Okayama, Japan

    Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
    Search for articles by this author
      Right thoracotomy approach has been gaining popularity in the repair of simple congenital heart diseases; especially, right vertical infra-axillary thoracotomy (RVIAT) provides a cosmetic benefit that is concealed and less evident but often requires peripheral cannulation. The surgical technique for RVIAT involved a 6-cm vertical incision in the right axillary fold, and cardiopulmonary bypass was established with ascending aorta and bicaval cannulations directly through the same surgical field. Intercostal block was routinely performed intra- and postoperatively to facilitate fast-track postoperative recovery. There is still a large potential to expand the selection criteria of RVIAT approach for further complicated diseases as a promising alternative to standard median sternotomy.

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      References

        • Konstantinov Igor E
        • Kotani Yasuhiro
        • Buratto Edward
        • et al.
        Minimally invasive approaches to atrial septal defect closure.
        JTCVS Techniques. 2022; (In press)https://doi.org/10.1016/j.xjtc.2022.02.037
        • Nicholson IA
        • Bichell DP
        • Bacha EA
        • et al.
        Minimal sternotomy approach for congenital heart operations.
        Ann Thorac Surg. 2001; 71: 469-472
        • Mishaly D
        • Ghosh P
        • Preisman S
        Minimally invasive congenital cardiac surgery through right anterior minithoracotomy approach.
        Ann Thorac Surg. 2008; 85: 831-835
        • Yoshimura N
        • Yamaguchi M
        • Oshima Y
        • et al.
        Repair of atrial septal defect through a right posterolateral thoracotomy: A cosmetic approach for female patients.
        Ann Thorac Surg. 2001; 72: 2103-2105
        • Bleiziffer S
        • Schreiber C
        • Burgkart R
        • et al.
        The influence of right anterolateral thoracotomy in prepubescent female patients on late breast development and on the incidence of scoliosis.
        J Thorac Cardiovasc Surg. 2004; 127: 1474-1480
        • Wang Q
        • Li Q
        • Zhang J
        • et al.
        Ventricular septal defects closure using a minimal right vertical infraaxillary thoracotomy: Seven-year experience in 274 patients.
        Ann Thorac Surg. 2010; 89: 552-555
        • Heinisch PP
        • Wildbolz M
        • Beck MJ
        • et al.
        Vertical right axillary mini-thoracotomy for correction of ventricular septal defects and complete atrioventricular septal defects.
        Ann Thorac Surg. 2018; 106: 1220-1227
        • Kandakure PR
        • Batra M
        • Garre S
        • et al.
        Direct cannulation in minimally invasive cardiac surgery with limited resources.
        Ann Thorac Surg. 2020; 109: 512-516
        • Yu S
        • Valencia MB
        • Roques V
        • et al.
        Regional analgesia for minimally invasive cardiac surgery.
        J Card Surg. 2019; 34: 1289-1296