Repair of Atrial Septal Defect Through a Right Anterolateral Thoracotomy: A Cosmetic and Safe Approach

Background: The operation for atrial septal defect (ASD) is considered a low risk procedure; the cosmetic result has become an important feature. For this reason the anterolateral thoracotomy is frequently used for closure of ASD. However, difficulty in aortic and caval cannulations to establish cardiopulmonary by pass (CPB) makes it rather awkward for some surgeons. Methods: We reviewed the short term results of a consecutive series of 17 patients in whom the atrial septal defect was closed through a right anterolateral thoracotomy. Results: The average cardiopulmonary bypass time was 36 minutes (range 22 to 53 minutes), with mean aortic cross clamp time of 21minutes (range 12 to 44 minutes). There was no preoperative or late mortality. The majority of patients are pleased with their cosmetic results. There were no other late complications. The mean age at operation was 27 years (range 4 to 53 years), and the mean body weight was 51 kg(range 14 to 155 kg). Al the repaired defects were secondum type ASD. Conclusion: Atrial septal defect can be safely repaired through a right anterior thoracotomy approach,with cosmetic results of avoiding median sternotomy.