Abstract： Objective To explore the curative effect of surgical repair with minimal right axillary incision in beating heart on congenital atrial septal defect(ASD) and ventricular septal defect(VSD).Methods Fifty-eight patients with congenital ASD and VSD(group A) received repair with minimal right axillary incision in beating hearts.Operations were performed using cardiopulmonary bypass(CPB) technique with mild hypothermia.Skin incisions were made at right armpit and extended into the chest through the fourth intercostal space.The pericardium was opened longitudinally 2 cm anterior to the right phrenic nerve.Aortic cannulation and superior and inferior vena cava cannulation were performed to establish conventional CPB.In addition,57 patients with congenital ASD and VSD(group B) received repair with median sternotomy in non-beating heart.The length of surgical incision,CPB time,operative time,the duration of postoperative mechanical ventilation,the length of hospital stay,chest drainage flow,the mortality and the incidence of complications were observed in both groups.Results There were significant differences in the length of surgical incision,CPB time,operative time,chest drainage flow,the duration of postoperative mechanical ventilation and the length of hospital stay between group A and group B(P<0.05 or P<0.01).But there were no differences in postoperative mortality and the incidence of residual shunting and atelectasis/pulmonary infection between the two groups(P>0.05).Conclusion The repair with minimal right axillary incision in beating heart for ASD and VSD is suitable for simple open-heart surgery with advantages of safety,reliability,minimal invasion,rapid postoperative recovery and beautiful incision appearance.
2011, Vol. 53 
