Heart Lung Circ. 2026 Jan 22:S1443-9506(25)01616-6. doi: 10.1016/j.hlc.2025.08.022. Online ahead of print.
ABSTRACT
AIM: This study aims to assess the safety, feasibility, and short-term outcomes of a modified right vertical infra-axillary thoracotomy (MRVIAT) technique, using a 2-5 cm incision without peripheral cannulation in patients of all ages with doubly committed subarterial ventricular septal defects (DCVSDs) and summarise associated surgical techniques.
METHOD: A retrospective review was performed on 171 patients with DCVSDs of all ages who underwent the MRVIAT procedure between 2022 and 2024.
RESULTS: The procedure was successfully completed in all 171 patients without conversion to median sternotomy or in-hospital mortality. The median age was 1.3 years (range, 0.1-39.0 years), with seven patients (4.1%) aged ≥18 years. The median weight was 10.2 kg (range, 3.8-86.6 kg). Among them, nine patients (5.3%) weighed ≤5 kg, 83 (48.5%) weighed ≤10 kg, 81 (47.4%) weighed 10-50 kg, and seven (4.1%) weighed ≥50 kg. Complications included mild residual shunting in two cases (1.2%), incision infection in one case (0.6%), and pulmonary infection in one case (0.6%). Over a median follow-up of 1.3 years (range, 0.3-2.5 years), no thoracic deformities or moderate-to-severe valvular regurgitation were observed.
CONCLUSIONS: The MRVIAT technique is a safe and viable option for the surgical treatment of DCVSD in patients across all age groups. It provides a minimally invasive approach with a small, inconspicuous incision and avoids peripheral cannulation, making it a promising alternative to median sternotomy.
PMID:41577590 | DOI:10.1016/j.hlc.2025.08.022