Abstract
Objective. To demonstrate the feasibility of use of anterolateral right thoracotomy for congenital heart disease repair under the cardiopulmonary bypass.
Material and methods. The total 319 patients were included in the study. All patients underwent surgery from January 1, 2011 to December 31, 2012. The main group comprised 238 patients (74.6%) with the anterolateral right thoracotomy were divided into 2 subgroups, i.e. 122 patients aged 6 months to 3 years and 116 patients aged 3 to 18 years. The control group (n=81 or 25.4%) included patients older than 1 month and younger than 18 years who underwent median longitudinal sternotomy.
Results. The group with the median longitudinal sternotomy has reported the prolong time of the operative access. Besides, the period of operative intervention through the thoracotomy access was longer in the group of patients older than 3 years in comparison with that of patients younger than 3 years. Comparison of thoracotomy and sternotomy methods did not appear practicable as there is no proved difference as for indicators of the cardiopulmonary bypass and aortic occlusion. Anterolateral right thoracotomy has been accompanied by less emptying through drainage. The prolonged stay in hospital in the group of patients with sternotomy has been associated first with the severity of congenital heart defect and concomitant pathology. In the subgroup of patients older than 3 years the “Bed days” occupancy indicator was higher in comparison with patients younger than 3 years (7.3 ± 0.8 versus 7.9 ± 1.7, p=0.02). Complications made up 5.5% in the main group and 7.4% in the control group. No group reported having infective complications.
Conclusion. Lateral right thoracotomy can be a method of choice of surgical access when repairing some congenital heart defects under the cardiopulmonary bypass with minimal predictors of the early postoperative complications.
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