Rightvertical axillary incision for atrial septal defect: a propensity score matched study
Abstract Background Atrial septal defect is one of the most common types of congenital heart disease. This study aims to explore the surgical and cosmetic effects of open-heart surgery with right vertical axillary incision for simple congenital heart disease in infants. Methods From June 2018 to Oct...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-10-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-022-01999-0 |
| _version_ | 1817979471574073344 |
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| author | Xiaohui Yang Yuan Hu Jie Dong Peng Huang Jinwen Luo Guangxian Yang Xicheng Deng |
| author_facet | Xiaohui Yang Yuan Hu Jie Dong Peng Huang Jinwen Luo Guangxian Yang Xicheng Deng |
| author_sort | Xiaohui Yang |
| collection | DOAJ |
| description | Abstract Background Atrial septal defect is one of the most common types of congenital heart disease. This study aims to explore the surgical and cosmetic effects of open-heart surgery with right vertical axillary incision for simple congenital heart disease in infants. Methods From June 2018 to October 2021, children who underwent direct surgery of atrial septal defect in our department were selected for a propensity score matched study. Those with direct surgery through the right vertical axillary incision were included in the right vertical axillary incision group. According to age and weight, propensity score matching method was employed to match children from the right vertical axillary incision group with those undergoing direct surgery through median sternotomy (median sternotomy group) at a 1:2 ratio. Surgery outcomes between two groups were compared to evaluate the effectiveness and safety of right vertical axillary incision group. Results The median incision length (median, [interquartile range]) in right vertical axillary incision group (4.8 cm, [4.0–5.0]) was shorter than that in median sternotomy group (p < 0.001). The median drainage volume of drainage tube of the right vertical axillary incision group (117.5 ml, [92.8,152.8]) was smaller than that of median sternotomy group (p = 0.021). While no residual bubbles cases in the left and right ventricles and outflow tract were present in the right vertical axillary incision group, 44% of residual air bubble rate in right ventricular outflow tract was detected in median sternotomy group (p = 0.001). Additional sedation and analgesia (p = 0.003), wound infection or poor healing (p = 0.047), thoracic deformity healing (p = 0.029) and appearance satisfaction questionnaire (p = 0.018) in the right vertical axillary incision group were better than those in the median sternotomy group. Conclusion Right axillary vertical incision can effectively reduce surgical trauma, accelerate postoperative rehabilitation. This surgical approach also provides better cosmetic effect, which is easily accepted by children’s families and worthy of further clinical application. |
| first_indexed | 2024-04-13T22:42:20Z |
| format | Article |
| id | doaj.art-e677d116758d4da5bcf56bea880ffb85 |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-04-13T22:42:20Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-e677d116758d4da5bcf56bea880ffb852022-12-22T02:26:34ZengBMCJournal of Cardiothoracic Surgery1749-80902022-10-011711810.1186/s13019-022-01999-0Rightvertical axillary incision for atrial septal defect: a propensity score matched studyXiaohui Yang0Yuan Hu1Jie Dong2Peng Huang3Jinwen Luo4Guangxian Yang5Xicheng Deng6Heart Center, Hunan Children’s HospitalDepartment of Echocardiography and Ultrasound, Hunan Children’s HospitalPediatrics Research Institute of Hunan Province, Hunan Children’s HospitalHeart Center, Hunan Children’s HospitalHeart Center, Hunan Children’s HospitalHeart Center, Hunan Children’s HospitalHeart Center, Hunan Children’s HospitalAbstract Background Atrial septal defect is one of the most common types of congenital heart disease. This study aims to explore the surgical and cosmetic effects of open-heart surgery with right vertical axillary incision for simple congenital heart disease in infants. Methods From June 2018 to October 2021, children who underwent direct surgery of atrial septal defect in our department were selected for a propensity score matched study. Those with direct surgery through the right vertical axillary incision were included in the right vertical axillary incision group. According to age and weight, propensity score matching method was employed to match children from the right vertical axillary incision group with those undergoing direct surgery through median sternotomy (median sternotomy group) at a 1:2 ratio. Surgery outcomes between two groups were compared to evaluate the effectiveness and safety of right vertical axillary incision group. Results The median incision length (median, [interquartile range]) in right vertical axillary incision group (4.8 cm, [4.0–5.0]) was shorter than that in median sternotomy group (p < 0.001). The median drainage volume of drainage tube of the right vertical axillary incision group (117.5 ml, [92.8,152.8]) was smaller than that of median sternotomy group (p = 0.021). While no residual bubbles cases in the left and right ventricles and outflow tract were present in the right vertical axillary incision group, 44% of residual air bubble rate in right ventricular outflow tract was detected in median sternotomy group (p = 0.001). Additional sedation and analgesia (p = 0.003), wound infection or poor healing (p = 0.047), thoracic deformity healing (p = 0.029) and appearance satisfaction questionnaire (p = 0.018) in the right vertical axillary incision group were better than those in the median sternotomy group. Conclusion Right axillary vertical incision can effectively reduce surgical trauma, accelerate postoperative rehabilitation. This surgical approach also provides better cosmetic effect, which is easily accepted by children’s families and worthy of further clinical application.https://doi.org/10.1186/s13019-022-01999-0Right vertical axillary incisionMedian sternotomy; congenital heart diseaseAtrial septal defectPostoperative complications |
| spellingShingle | Xiaohui Yang Yuan Hu Jie Dong Peng Huang Jinwen Luo Guangxian Yang Xicheng Deng Rightvertical axillary incision for atrial septal defect: a propensity score matched study Journal of Cardiothoracic Surgery Right vertical axillary incision Median sternotomy; congenital heart disease Atrial septal defect Postoperative complications |
| title | Rightvertical axillary incision for atrial septal defect: a propensity score matched study |
| title_full | Rightvertical axillary incision for atrial septal defect: a propensity score matched study |
| title_fullStr | Rightvertical axillary incision for atrial septal defect: a propensity score matched study |
| title_full_unstemmed | Rightvertical axillary incision for atrial septal defect: a propensity score matched study |
| title_short | Rightvertical axillary incision for atrial septal defect: a propensity score matched study |
| title_sort | rightvertical axillary incision for atrial septal defect a propensity score matched study |
| topic | Right vertical axillary incision Median sternotomy; congenital heart disease Atrial septal defect Postoperative complications |
| url | https://doi.org/10.1186/s13019-022-01999-0 |
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