Abstract：Objective To summarize the key point of surgical techniques for the complete correction of pediatric tetralogy of Fallot (TOF) through right subaxillary minithoractomy.Methods Three hundred and forty-six TOF cases (159 males, 187 females), who underwent radical correction through right subaxillary minithoractomy from January 1997 to October 2013, were analyzed retrospectively. The mean age was (1.9±1.2) years old and the mean body weight was (9.7±2.4)kg, Associated cardiac lesions included patent foramen ovale (43 cases), atrial septal defect(22 cases), patent ductus arteriosus(10 cases), persistent left superior vena cava(10 cases), subaortic membrane(7 cases) and mitral valve insufficiency(1 cases). Corrections with transannular patch were performed in 205 cases, right ventricular outflow tract patch in 141 cases.Results There were 7 early death. The mean time of CPB was (90±24) min and the mean aorta clamping time was (64±17) min, the postoperative average mechanical ventilation time was(4-165)h, the stay time in ICU was (3.2±1.7) days. The volume of average postoperative drainage was (138±91) ml, the average duration of chest tube was (2.5±0.9) days. Postoperative complications were observed in 36 patients (1.04%). Among them, low cardiac output syndrome in 17 cases (5 death cases), severe pulmonary infection in 2 cases ( 1 death case), perfusion lung in 5 cases( 1 death case), the right lung injury in 7 cases, phrenic nerve injury in 4 cases, the ventricular septal defect with residual shunt in 2 cases and chylothorax in 2 cases.Conclusions The right subaxillary minithoractomy with proper exposure is safe enough for the correction of TOF.
李晓锋,苏俊武,张晶,范祥明,李志强,贺彦,李玲,张辉,程沛,刘迎龙. 右侧腋下小切口入路矫治法洛四联症的技术要点分析[J]. 中华解剖与临床杂志, 2014, 19(3): 180-182.
Li Xiaofeng, Su Junwu, Zhang Jing, Fan Xiangming, Li Zhiqiang, He Yan, Li Ling, Zhang Hui, Cheng Pei, Liu Yinglong. The key surgical techniques for the complete correction of tetralogy of Fallot through the righ mini-lateral-thoracotomy. Chinese Journal of Anatomy and Clinics, 2014, 19(3): 180-182.
Liu YL, Zhang HJ, Sun HS, et al. Repair of cardiac defects through a shorter right lateral thoracotomy in children[J]. Ann Thorac Surg, 2000, 70(3): 738-741.
[5]
Li J, Liu Y, Yu C, et al. Comparison of incisions and outcomes for closure of ventricular septal defects[J]. Ann Thorac Surg, 2008, 85(1): 199-203.
2014, Vol. 19 
