Title: Comparison of Thoracotomy with Median Sternotomy Approach for Intra Cardiac Operations
Authors: Dr. Ishtyak Ahmed Mir, Dr. Abdul Ghani Ahangar
DOI: http://dx.doi.org/10.18535/jmscr/v3i9.12
Minimally invasive approaches for cardiac surgery are gaining popularity, especially in patients who are young, have simple intra cardiac septal defects, mitral and tricuspid valve disease. The study was conducted to find the advantages and disadvantages of right anterior thoracotomy over median sternotomy with regard to length of incision, opening and closing time, types of material used, postoperative drainage, morbidity, mortality and postoperative hospital stay. The study included 100 patients, with 88 in 2nd through 4th decade of life. In 50% of the patients, the heart was approached by median sternotomy and in others by right anterior thoracotomy incision. The length of thoracic incision, chest opening / closing time, material used, postoperative drainage and hospital stay was significantly less in thoracotomy group. Repair of atrial septal defect was the common operation performed. In thoracotomy group aortic cannulation was difficult in few and fracture to costochondral junction was observed. None of the patients in thoracotomy group needed sternotomy, rib resection or peripheral cannulation. Cosmetic results were good in thoracotomy group. It is recommended that for operations in all patients with atrial septal defact, mitral and tricuspid valve diseases, the heart should be approached through right anterior thoracotomy. Key words:- Thoracotomy, Sternotomy, 1. Krishnanaik Shivaprakasha, Kona Samba Murthy, Robert Coelho, Ravi Agarwal, Suresh G Rao, Claude Planche, Kotturathu Mammen Cherian. Role of Limited posterior thoracotomy for open-heart surgery in the current era, Ann Thorac Surg 1999; 68: 2310-13. 2. Barrat-Boyes BG. Right anterolateral thgoracotomy for cardiopulmonary bypass. In: Kirklin JW, Barrat Boyes BG. Eds. Cardiac Surgery Is ted. New York: Churchill Livingstone 29-92; 1988. 3. 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