Objective:This study was conducted to explore the efficacy and safety of minimally invasive surgery for simple congenital heart diseases through small right axillary incision.Methods:Clinical data of 250 children who underwent septal defect repair at Teda International Cardiovascular Hospital from January 2019 to October 2022 were retrospectively analyzed.All operative procedures were performed through small right subaxillary incision(n=125,SRSI group)or conventional median sternotomy(n=125,CMS group).Procedure-related parameters including cardiopulmonary bypass time,aortic blocking time,operation time,postoperative drainage,time of ventilator use,length of stay in Intensive Care Unit(ICU),stress indicators including cortisol,corticotropic hormone(ACTH),nerve injury markers including neuron-specific enolase(NSE),central nerve system specific protein S100β,and inflammatory factors including tumor necrosis factor(TNF)-α,interleukin(IL)-6,C-reactive protein(CRP),as well as clinical efficacy and incidence of complications(chest malformation,incision or mediastinal infection)were compared between the two groups.Results:Compared to CMS group,cardiopulmonary bypass time,aortic blocking time,time of ventilator use,and length of stay in ICU were shorter,complication rate was lower,and treatment response was better in SRSI group(all P＜0.05).Although serum levels of cortisol,ACTH,NSE,S100β,TNF-α,IL-6,and CRP were increased one day after the procedure in both groups,these measurements were significantly reduced in SRSI group compared to CMS group(P＜0.05).Conclusion:Our results suggest that minimally reduce surgery for congenital heart disease through small right subaxillary incision may reduce the stress and inflammatory response,reduce the risk of brain injury and complications.
Minimally invasive surgery with right-axillary small incisionTraditional thoracotomy surgerySimple congenital heart diseaseClinical efficacy
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