Right Anterolateral Thoracotomy for Repair of Atrial Septal Defects in Young Female Patients

We performed a right anterolateral thoracotomy for atrial septal defect closure in young female patients to achieve a good cosmetic result. From December 1995 to June 1997, 25 female patients with a mean age of 10 ± 3 years (range, 4 to 22 years) underwent repair of atrial septal defects that comprised 24 ostium secundum and one sinus venosus. The length of the incision varied from 10 to 14 cm. The ascending aorta was used for arterial cannulation except in 2 cases where the external iliac artery was cannulated. Repairs were performed under crystalloid cardioplegia except in 2 patients where fibrillation was employed. In 5 patients, autologous glutaraldehyde-treated pericardial patch closure was used and the defects were closed directly in the other 20. All patients underwent echocardiography in the intensive care unit and 3 months after the repair. There was no operative or late mortality and no morbidity related to the thoracotomy approach. We concluded that a right anterolateral thoracotomy incision is a safe and effective alternative to a median sternotomy for repair of atrial septal defects and it provided a superior cosmetic result in these young female patients.