Our results of cardiac surgery performed with a right infra axillary mini thoracotomy

Abstract

The aim of the study is to share the technique and results of heart surgery performed with right infra-axillary mini thoracotomy. Materyal and Method: Between March 2013 and July 2014, 16 heart operations were performed with right infra-axillary mini thoracotomy incision. Patient data were analyzed retrospectively. These are 6 mitral valve replacement (MVR), 3 aortic valve replacement (AVR), 2 AVR+MVR, 2 atrial septal defect (ASD) repair, 1 myxoma excision. One of them is AVR+tricuspid ring annuloplasty operation and MVR performed due to reoperation. Radiofrequency (RF) ablation was also applied to 1 patient who underwent MVR due to atrial fibrillation. In these operations, thoracotomy was performed through the right anterior infra-axillary line. A parabolic incision of 6-8 cm was made at the 3rd intercostal space (ICA) for aortic valve interventions and at the 4th ICA level for other valve interventions. No special surgical instruments were used in the operations except standard surgical instruments. All cannulation procedures were carried out through the existing thoracotomy incision. Results: No mortality or morbidity was observed as a result of the operations. The mean extracorporeal circulation (ECC) time was 95±11 minutes, and the mean cross clamp (CC) time was 61±9 minutes. There was an average of 380±35 cc drainage. Extubation time was 7±2.3 hours on average. All patients were taken to the service after 1±0.5 day of intensive care treatment. They were discharged from the hospital in an average of 6±1.5 days. Incision site infection was not observed in any patient. No patients were revised due to bleeding. One patient who was ablated for atrial fibrillation (AF) developed postoperative AF again. He was discharged with medical treatment and speed control. Conclusion:In this study, we think that heart surgeries with right infra-axillary mini thoracotomy incision may be a good alternative to standard sternotomy and other minimally invasive methods in heart surgery. With standard surgical instruments and cannulation through a single incision, not only the mitral valve but also the aortic valve, tricuspid valve and other cardiac pathologies can be easily intervened. However, very good results are obtained in patients cosmetically.