• 作者：Juan Miguel Gil-Jaurena^a ; ^{giljaurena@gmail.com} ; Juan-Ignacio Zabala^b ; Lourdes Conejo^b ; Victorio Cuenca^b ; Beatriz Picazo^b ; Clara Jimé ; nez^b ; Rafael Castillo^a ; Manuel Ferreiros^a ; Manuel de Mora^b ; Julio Gutié ; rrez de Loma^a
• 关键词：Comunicació ; n interauricular ; Submamaria ; Axilar ; Canulació ; n
• 刊名：Revista Espa帽ola de Cardiolog铆a
• 出版年：2011
• 期刊代码：pca308_03008932
• 类别：med
• 出版时间：March 2011
• 卷：64
• 期：3
• 页码：208-212
• 文件大小：230 K

Introduction and objectives

Minimally invasive approaches in less-complex cardiac procedures can avoid unpleasant cosmetic results. Moreover, surgery can be scheduled in younger patients. In previous papers, we compared submammary and midline sternotomy. We present our initial experience with an axillary, compared to submammary, approach to repair atrial septal defects under extracorporeal circulation.

Methods

20 patients are included: 10 in the submammary group (7 ostium secundum, 2 sinus venosus, 1 ostium primum) and 10 in the axillary group (7 ostium secundum, 3 sinus venosus). Mean age and weight are 6.4 卤 3.62 years (range 3-13) and 23.5 卤 8.74 Kg (range 12-38) in the submammary group, and 5.5 卤 2.04 years (range 3-9) and 19.7 卤 5.88 Kg (range 14-29) in the axillary one, respectively. Muscles are spared (pectoralis in submammary and latissimus in axillary). The whole procedure (cannulation and correction) is performed through a single incision, with no side ports.

Results

No residual defects were found at discharge. Surgical approach maneuvers are more cumbersome through the axillary than the submammary approach. In a peer comparison, extracorporeal circulation and cross-clamp time were similar in both groups (P > .05).

Conclusions

1. Axillary approach is as safe as submammary access in selected patients and for defects approached through the atrium. 2. Cosmetic result is excellent.

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