Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-10T10:07:41.437Z Has data issue: false hasContentIssue false
  • English
  • Français

Midaxillary lateral thoracotomy for closure of atrial septal defects in pre-pubescent female children: reappraisal of an “old technique”

Published online by Cambridge University Press:  24 May 2005

Christian Schreiber ,
Sabine Bleiziffer  and
Rüdiger Lange
Christian Schreiber
Affiliation:
Clinic of Cardiovascular Surgery, German Heart Center Munich at the Technical University, Munich, Germany
Sabine Bleiziffer
Affiliation:
Clinic of Cardiovascular Surgery, German Heart Center Munich at the Technical University, Munich, Germany
Rüdiger Lange
Affiliation:
Clinic of Cardiovascular Surgery, German Heart Center Munich at the Technical University, Munich, Germany
Get access Rights & Permissions [Opens in a new window]

Abstract

Our long-term follow-up has revealed that symmetrical development of the breasts is significantly impaired in pre-pubescent female patients subsequent to an anterolateral thoracotomy. Although standard posterolateral and anterolateral right-sided thoracotomies are used for correction of “simple” cardiac lesions such as patency of the arterial duct, coarctation of the aorta, or atrial septal defect, the required partial transection of large muscle groups, and injury to the developing tissues of the breast, may contribute to an unfavourable cosmetic outcome. Over the years, many surgeons, mostly specialising in thoracic procedures, have advocated mini- or axillary thoracotomies. In an attempt to improve surgical and cosmetic outcome, we have now adopted such a muscle-sparing approach, using a small horizontal midaxillary incision. We have now successfully employed the technique to close atrial septal defects in the oval fossa in 17 pre-pubescent females.

Keywords

Minimal invasive cardiac surgeryposterolateral thoracotomyanterolateral thoracotomy
Type
Brief Report
Information
Cardiology in the Young , Volume 13 , Issue 6 , December 2003 , pp. 565 - 567
Copyright
© 2003 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Landreneau RJ, Pigula F, Luketich JD, et al. Acute and chronic morbidity differences between muscle-sparing and standard lateral thoracotomies. J Thorac Cardiovasc Surg 1996; 112: 1346–1351.Google Scholar
Bendetti F, Vighetti S, Ricco C, et al. Neurophysiologic assessment of nerve impairment in posterolateral and muscle-sparing thoracotomy. J Cardiovasc Surg 1998; 115: 841–847.Google Scholar
Nomori H, Ohtsuka T, Horio H, Naruke T, Suemasu K. Difference in the impairment of vital capacity and 6-minute walking after a lobectomy performed by thoracoscopic surgery, an anterior limited thoracotomy, an anteroaxillary thoracotomy, and a posterolateral thoracotomy. Surg Today 2003; 33: 7–12.Google Scholar
Noirclerc M, Dor V, Chauvin G, et al. Extensive lateral thoracotomy without muscle section. Ann Chir Thorac Cardiovasc 1973; 12: 181–184.Google Scholar
Becker RM, Munro DD. Transaxillary minithoracotomy: the optimal approach for certain pulmonary and mediastinal lesions. Ann Thorac Surg 1976; 22: 254–259.Google Scholar
Mitchell R, Angell W, Wuerflein R, Dor V. Simplified lateral chest incision for most thoracotomies other than sternotomy. Ann Thorac Surg 1976; 22: 284–286.Google Scholar
Yang X, Wang D, Wu Q. Repair of atrial septal defect through a minimal right vertical infra-axillary thoracotomy in a beating heart. Ann Thorac Surg 2001; 71: 2053–2954.Google Scholar
Bleiziffer S, Schreiber C, Burgkart R, et al. Impaired development of the right mamma after right anterolateral thoracotomy in pre-pubescent female patients. Cardiol Young 2003; 13 (Suppl 1): 86.Google Scholar
Giamberti A, Mazzera E, Di Chiara L, Ferretti E, Pasquini L, Di Donato RM. Right submammary minithoracotomy for repair of congenital heart defects. Eur J Cardiothorac Surg 2000; 18: 678–682.Google Scholar
Yoshimura N, Yamguchi M, Oshima Y, Oka S, Ootaki Y, Yoshida M. Repair of atrial septal defect through a right posterolateral thoracotomy: a cosmetic approach for female patients. Ann Thorac Surg 2001; 72: 2103–2105.Google Scholar