Clinical application of right vertical axillary incision for simple congenital heart disease in children

AIM:To evaluate the advantages and disadvantages of right vertical axillary incision for correction of atrial septal defect (ASD), ventricular septal defect (VSD) and pulmonary stenosis (PS) by analyzing the clinical data of patients with ASD, VSD or PS. METHODS: In this single-centered retrospective study, clinical data were collected and retrospectively analyzed in 280 patients <18 years of age who underwent surgery of the right vertical axillary incision for correction of congenital heart disease from January 2011 to October 2012. Cardiopulmonary bypass time, aortic cross-clamp time and primary complications were examined. RESULTS: All operations were successful without serious complications and no operative deaths occurred. The average time of extracorporeal circulation and aorta blocking time was 52.35 min and 22.36 min, respectively. Complications included pericardial effusion (19 cases), pericardial pneumatosis (two cases), right lower lung infection (27 cases), right lung infection (two cases), double lung infection (one case), right pleural thickening and adhesion (one case), right gas-liquid chest (11 cases) with lung compression (three cases), right side pneumothorax (four cases), right upper lobe collapse (three cases), subcutaneous emphysema of right chest wall (two cases), left-sided pleural effusion (three cases), bilateral pleural effusion (one case), right lateral rib fractures and pleural effusion (one case). CONCLUSION: Minithoracotomy, less hemorrhage, quick recovery and concealed incision are some advantages of right vertical straight incision. Application of right vertical axillary incision should be based on proper consideration of the patients’ weight and age, correct diagnosis, and anticipation and prevention of postoperative pulmonary complications.