Clinical experience and follow-up of right ventricular double-chamber heart in children treated via a right lateral minithoracotomy approach: a single-center study

AIM To evaluate the safety, benefits, and limitations of right-side small incision approach in the treatment of double chambered right ventricle in children. Based on follow-up, the present study aims to optimize the surgical procedures and to provide guide for clinical practice.

METHODS A retrospective analysis was conducted on a total of 60 children meeting the inclusion criteria with double chambered right ventricle. Postoperative clinical indexes and follow-up results were compared between the right small incision (experimental group, n=28) and the median sternal incision (control group, n=32).

RESULTS There were no significant differences in key indicators such as gender, age, body mass, systolic blood pressure difference across the stenosis site, and VSD diameter between the two groups of patients. Preoperative electrocardiogram examination showed that the vast majority of patients (56 out of 60) had high right ventricular voltage, but there was no statistical difference between the two groups. Compared with the control group, the study group had slightly longer ascending aortic occlusion time (P<0.01), but had lower red blood cell transfusion volume, shorter mechanical ventilation time, lower postoperative 24-hour drainage volume, shorter ICU stay, and shorter total hospitalization time, all of which were significantly better than the control group (P<0.01). In the third year after surgery, the pediatric quality of life questionnaire (Version 4.0) was used to evaluate the emotional function of the children. Compared with the control group, the study group had a lower score for abnormal emotional function (P<0.01), but there was no statistical difference in growth and development indicators such as height and body weight. There were no lost cases during follow-up, and there were no cases of thoracic deformities in the study group. In the control group, there were 2 cases of chicken breast and 1 case of funnel chest.

CONCLUSION The right small incision approach in children with right ventricle double chamber heart in Children is less traumatic and aesthetically favorable, and proves to be safe and effective. This surgery is shown to reduce the risk of long-term complications such as thoracic deformity and emotional disturbances.