Short-Term Outcomes of Right Vertical Infra-Axillary Thoracotomy Approach for Partial Atrioventricular Septal Defect Repair

Objectives The objective of this study was to evaluate the postoperative outcome of minimally invasive surgical repair of partial atrioventricular septal defects (AVSD), focusing on surgical safety and postoperative left atrioventricular (AV) valve function. Methods We retrospectively reviewed the clinical data of 32 consecutive patients who underwent minimally invasive right vertical infra-axillary thoracotomy approach for repair of partial AVSD at our institution between January 2020 and December 2023. Left AV valve function was evaluated by echocardiography, and Fisher's exact test was used to compare the number of patients who had moderate left AV valve regurgitation pre- and 1-year postoperatively. Results The median age at repair was 2.4 years, and the median body weight was 12 kg. The mean follow up after surgical repair was 2.8 years, with no mortality or surgical reintervention. There was no conversion to median sternotomy, hemorrhage, pneumothorax, or diaphragm paralysis. However, complete heart block developed in 1 patient (1.5 years old, 9 kg). Thirty patients underwent isolated left AV Valve cleft closure, and 4 patients underwent additional left AV valve annuloplasty. Preoperative echocardiogram showed moderate or more left AV valve regurgitation in 19/32 patients (60%), which improved significantly after the surgical repair. Postoperative echocardiograms showed mild or less left AVvalve regurgitation in 31/32 patients (97%) ( P < .01). However, 1 patient (4 months old, 5.5 kg) had moderate left AV valve regurgitation from a residual cleft. Conclusions Right vertical infra-axillary thoracotomy can be safely performed in patients with partial AVSD, and the short-term outcome of the left AV valve function was satisfactory.