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《Chinese Journal of Cardiovascular Research》 2018-04
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Clinical experience of atrial septal defect repair by right subaxillary small incision on beating heart

CHENG Xiang-jun;CEHN Ruo-han;WANG Guang-kuo;Cardiovascular Surgery,Jiangmen Central Hospital;  
Objective To summarize the clinical experience of atrial septal defect repair by right subaxillary straight incision under cardiopulmonary bypass and beating heart, and to explore its indications and technical points. Methods From January 2011 to December 2016, we completed a total of 92 cases with right subaxillary incision open heart surgery, including 52 cases of male, female 40 cases. Among them, 2 cases complicated with partial anomalous pulmonary venous drainage, 6 cases with moderate or higher pulmonary hypertension, and 39 cases underwent three tricuspid valvuloplasty at the same time. All operations were performed under general anesthesia,cardiopulmonary bypass, and beating heart. Patients take the left decubitus, the incision in the axillary midline and the anterior axillary line, skin incision length is about 5-8 cm, after about third or fourth intercostal incision and pericardial suspension, ascending aorta and extracorporeal circulation, inferior vena cava intubation through the right atrial incision repair of atrial septal defect and three tricuspid valve repair. Results All groups were successfully completed surgery, no surgical death; no malignant arrhythmia and thrombosis, without brain postoperative complications, pneumothorax and subcutaneous emphysema occurred in 2 cases, 1 case of atelectasis, 1 case was followed up for 1-2 mm residual shunt. Conclusion Right subaxillary small incision in beating heart repair of atrial septal defect surgery is safe, reliable, good cosmetic effect, less trauma, shorter operative time and postoperative recovery fast, patient and family satisfaction rate is high, it is worthy of clinical promotion.
【CateGory Index】: R654.2
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