Right anterolateral thoracotomy for repair of atrial septal defect

Background. To procure a cosmetic incision in female patients, we performed operation on atrial septal defects through a right anterolateral thoracotomy. Methods. From 1984 to 1994, 80 female patients with a mean age of 24 +/- 13 years (ranging from 12 to 62 years) underwent right anterolateral thoracotomy for atrial septal defect repairs. Defects repaired included 62 ostium secundum, 12 sinus venosus, 2 low septal defect, and 4 ostium primum. The right iliac external artery was systematically used for arterial cannulation, through a cosmetic incision. Repairs were always performed under fibrillation, except in the 4 ostium primum defects, for which cardioplegia was used. Results. There was no operative or late mortality, and no morbidity directly related to the thoracotomy approach. Conclusions. The right thoracotomy incision appears to be a safe and effective alternative to median sternotomy for repair of atrial septal defects.