Right Anterolateral Thoracotomy an Alternative to Median Sternotomy for Closure of Atrial Septal Defect: A Cosmetic Approach in Young Females
Journal Title: Nepalese Heart Journal - Year 2015, Vol 12, Issue 1
Abstract
background andaims: Atrial septal defect operation is a safe and low-risk procedure. Cosmetic results have been an important issue, so right anterolateral thoracotomy approach has been used for repair. We present minimally invasive ASD closure via limited right anterolateral thoracotomy, as our early experience in road of minimally invasive cardiac surgery. Methods: This study was done in the Manmohan Cardiothoracic and Transplant Center in the time period of 2012 to 2013. The study included 70 patients aged 15 – 35 years old (22.1±5.5) admitted for surgical repair of their secundum atrial septal defects. The patients were randomly allocated into one of two groups according to the approach used in their operation. Right anterolateral thoracotomy(RALT) group included 35 patients operated via right anterolateral thoracotomy.and median sternotomy(MS) group included 35 patients operated via the median sternotomy. result: Of 70 patients only 63 patients meet the criteria for analysis. There was no statistically significant difference between the 2 groups regarding their demographic data and duration of operation. Postoperative pleural/pericardial effusion and pneumothorax occurred in 2.1% of patients in MS and 6.6% in Right anterolateral thoracotomygroup (p= 0.001). Total in hospital pain score was high in sternotomy group than thoracotomy group, but did not reach statistically significant values. There was no operative or late mortality or morbidity in the early follow-up (range, 1 m to 2 years, mean 1.34 yrs). Conclusion: RALT is a safe and effective alternative approach to MS incision for ASD closure.
Authors and Affiliations
Ravi Kumar Baral| Department of Cardiothoracic and Vascular surgery Manmohan Cardiovascular Thoracic and Transplant Center (MCVTC), Institute of Medicine, Maharajgunj, Kathmandu, Bhagawan Koirala| Department of Cardiothoracic and Vascular surgery Manmohan Cardiovascular Thoracic and Transplant Center (MCVTC), Institute of Medicine, Maharajgunj, Kathmandu
Patterns of Valvular Involvement in Rheumatic Heart Disease patients taking Benzathine Penicillin at Shahid Gangalal National Heart Centre, Kathmandu, Nepal
Background and Aims: Acute rheumatic fever and rheumatic heart disease constitute an important public health problem in the developing countries. The disease results from an abnormal autoimmune response to a group A st...
Pattern of left main stenosis at a tertiary cardiac center of Nepal
Background and Aims: Left main stem stenosis is defned as a lesion occupying more than 50% of the lumen diameter. Various studies have shown that left main stem stenosis occurs in 4%-6% of all the patients undergoing c...
Percutaneous Transluminal Mitral Commisuriotomy for Mitral Stenosis in Shahid Gangalal National Heart Centre, Kathmandu, Nepal
Mitral stenosis (MS) is almost invariably the result of long term complication of rheumatic fever. Based upon the nature and severity of MS, patients can be managed with medical treatment, percutaneous transvenous mitr...
Acute ST segment elevaton MI with Normal Coronaries
A 45 year-old man with no history of cardiac disease presented to the emergency department with typical angina chest pain of >24 hours duraton. He was not thormbolyzed due to late presentaton. Having elevated troponin a...
Obstetric outcome in patients with rheumatic heart disease: experience of a tertiary hospital
Background and Aims: Pregnancy in patients with rheumatic heart disease has always been challenging. Haemodynamic changes in pregnancy with diseased heart may cause adverse maternal and fetal outcome. Methods: A prospe...