Lower Mid-line Skin Incision with Full Sternotomy as an Approach for Pediatric Atrial Septal Defect Repair

(Department of Surgery, Keio University School of Medicine, Tokyo, Japan)

Ichiro Kashima Ryo Aeba Toshiyuki Katogi
Kenichi Hashizume Yoshimi Iino Shiaki Kawada
Recently, the demand for better cosmetic outcomes in pediatric cardiovascular operations has been growing. Between May 1998 and April 1999Csix children aged 2 to 6 years with an ostium secundum type of atrial septal defect underwent reparative operations that used an approach consisting of a lower mid-line skin incision with full sternotomy. A 4.2-5.8cm vertical skin incision (meanC4.9}0.3cmjwas made between the level of the nipple and the xyphoid process. Comparison between this series and a group of weight-matched patients who underwent conventional operations revealed no significant differences in operation timei166.0}12.0vs. 147}8.4min), cardiopulmonary bypass timei33.2}4.0vs. 32.2}2.4min), aortic cross-clamp timei13.8}2.3vs. 12.3}1.3min), or the reduction in the hemoglobin concentration in blood on the first postoperative dayi1.7}0.3vs. 2.9}0.6g/dl). The surgical wound was not associated with any complications in our series, including wound infection or subcutaneous hematoma. Our technique appears to be safe and provide satisfactory cosmetic outcome.
@Jpn. J. Cardiovasc. Surg. 29: 225-228 (2000)