Repair of partial atrioventricular septal defect through a modified right vertical infra-axillary thoracotomy: a single-center experience - Report - MDSpire
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Repair of partial atrioventricular septal defect through a modified right vertical infra-axillary thoracotomy: a single-center experience
Clinical Report: Modified Right Vertical Infra-Axillary Thoracotomy for PAVSD
Overview
The modified right vertical infra-axillary thoracotomy (MRVIAT) technique demonstrates safety and efficacy in repairing partial atrioventricular septal defect (PAVSD) across a wide age range, with no significant complications reported in a cohort of 64 patients. This approach offers aesthetic advantages and aligns with the trend towards minimally invasive cardiac surgery.
Background
The management of congenital heart defects, particularly atrioventricular septal defects, has evolved significantly, with a shift towards minimally invasive techniques that reduce surgical trauma and improve recovery times. The MRVIAT method integrates thoracoscopic principles to enhance surgical outcomes while minimizing the psychological impact of traditional median sternotomy incisions. Understanding the viability of MRVIAT is crucial for optimizing surgical strategies in pediatric and adult populations.
Data Highlights
Parameter
Value
Number of patients
64
Average age
12.8 ± 16.5 years
Median body mass
55.8 kg
Average operative duration
177.0 ± 46.4 min
Mean duration of cardiopulmonary bypass
98.2 ± 34.4 min
Mean aortic cross-clamp duration
64.5 ± 23.1 min
Reoperation due to patch dehiscence
1 patient
Key Findings
All 64 patients successfully underwent PAVSD repair without conversion to median sternotomy.
No fatalities or significant complications were observed during the study.
The average operative duration showed a decreasing trend, indicating a learning curve effect.
No moderate or severe valvular regurgitation was noted during follow-up.
Cardiac function remained within normal parameters for all individuals post-surgery.
Clinical Implications
The MRVIAT technique offers a promising alternative to traditional surgical approaches for PAVSD, particularly in terms of aesthetic outcomes and reduced recovery times. Clinicians should consider this method for suitable candidates, especially given its favorable safety profile and the potential for improved patient satisfaction.
Conclusion
The MRVIAT method is a secure and effective option for repairing PAVSD, demonstrating positive outcomes across a diverse patient age range. Continued evaluation and refinement of this technique may further enhance its application in congenital cardiac surgery.
