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Impact of right anterolateral thoracotomy with a new approach on breast development: survey analysis of female cardiac surgery patients

Part of: Surgery

Published online by Cambridge University Press:  28 February 2022

Başak Soran Turkcan Open the ORCID record for Başak Soran Turkcan [Opens in a new window] ,
Atakan Atalay ,
Emre Kulahcioglu  and
Irfan Tasoglu
Başak Soran Turkcan*
Affiliation:
Department of Pediatric Cardiovascular Surgery, Ministry of Health Ankara City Hospital, Ankara, Turkey
Atakan Atalay
Affiliation:
Department of Pediatric Cardiovascular Surgery, Ministry of Health Ankara City Hospital, Ankara, Turkey
Emre Kulahcioglu
Affiliation:
Department of Pediatric Cardiovascular Surgery, Ministry of Health Ankara City Hospital, Ankara, Turkey
Irfan Tasoglu
Affiliation:
Department of Cardiovascular Surgery, Minister of Health Ankara City Hospital, Ankara, Turkey
*
Author for correspondence: B. Soran Turkcan, MD, Department of Pediatric Cardiovascular Surgery, Ministry of Health Ankara City Hospital, Ankara, Turkey. Tel: +90 5324776627. E-mail: basaksoran@gmail.com
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Abstract

Introduction:

Our aim was to present the effects of submammarian thoracotomy by our new approach to breast development in young female patients between 8 and 14 years old.

Methods:

Atrial septal defect closure was performed in 55 female patients between 8 and 14 years old at the time of operation between January 2010 and January 2018 by median sternotomy or right anterolateral thoracotomy. These patients were called for a follow-up visits, breast examination were performed, and a questionnaire of 10 questions was applied.

Results:

According to the answer given by the patients to the question of “how would you describe your scar” showed that the surgical method satisfies all patients cosmetically in study group. The overall satisfaction rate for the cosmetic results of operation was 100% versus 41.1%, respectively. The percentage of patients said no to the question “Do you experience lack of self-confidence related your scar” was significantly higher than the control group (p < 0.001). The percentage of those who said yes to the question “Would you like to be operated with the same approach if you will have surgery again?” in the study group was significantly higher than the control group (p = 0.002).

Conclusions:

We consider that our procedure is safe and effective with improved cosmetic results compared to median sternotomy which also confers many advantages such as less trauma, less pain, faster recovery, and shorter hospital stay. This study presents one of the largest series of paediatric patients operated by submammarian thoracotomy.

Keywords

Atrial septal defect closureright anterolateral thoracotomysubmammarian thoracotomybreast development
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 2 , February 2023 , pp. 271 - 279
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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References

Däbritz, S, Sachweh, J, Walter, M, Messmer, BJ. Closure of atrial septal defects via limited right anterolateral thoracotomy as a minimal invasive approach in female patients. Eur J Cardiothorac Surg 1999; 15: 18–23. DOI 10.1016/s1010-7940(98)00267-x.CrossRefGoogle ScholarPubMed
Xu, M, Zhu, S, Wang, X, Huang, H, Zhao, J. Two different minimally ınvasive techniques for female patients with atrial septal defects: totally thoracoscopic technique and right anterolateral thoracotomy technique. Ann Thorac Cardiovasc Surg 2015; 21: 459–465. DOI 10.5761/atcs.oa.15-00005.CrossRefGoogle ScholarPubMed
Vida, VL, Tessari, C, Fabozzo, A, et al. The evolution of the right anterolateral thoracotomy technique for correction of atrial septal defects: cosmetic and functional results in prepubescent patients. Ann Thorac Surg 2013; 95: 242–247. DOI 10.1016/j.athoracsur.2012.08.026.CrossRefGoogle ScholarPubMed
De Silva, NK. Breast development and disorders in the adolescent female. Best Pract Res Clin Obstet Gynaecol 2018; 48: 40–50. DOI 10.1016/j.bpobgyn.2017.08.009.CrossRefGoogle ScholarPubMed
Tasoglu, İ, Avci, T, Koca, S, et al. Atrial septal defect closure via right mini-thoracotomy: our single center experience. TurkGogus Kalp Dama 2017; 25: 565–572.CrossRefGoogle Scholar
Bleiziffer, S, Schreiber, C, Burgkart, R, et al. The influence of right anterolateral thoracotomy in prepubescent female patients on late breast development and on the incidence of scoliosis. J Thorac Cardiovasc Surg 2004; 127: 1474–1480. DOI 10.1016/j.jtcvs.2003.11.033.CrossRefGoogle ScholarPubMed
Dietl, CA, Torres, AR, Favaloro, RG. Right submammarian thoracotomy in female patients with atrial septal defects and anomalous pulmonary venous connections. Comparison between the transpectoral and subpectoral approaches. J Thorac Cardiovasc Surg 1992; 104: 723–727.CrossRefGoogle ScholarPubMed
Tiete, AR, Sachweh, JS, Kozlik-Feldmann, R, Netz, H, Reichart, B, Daebritz, SH. Minimally invasive surgery for congenital heart defects in paediatric patients. Thorac Cardiovasc Surg 2002; 50: 271–275. DOI 10.1055/s-2002-34582.CrossRefGoogle ScholarPubMed
Isik, O, Ayik, MF, Akyuz, M, Daylan, A, Atay, Y. Right anterolateral thoracotomy in the repair of atrial septal defect: effect on breast development. J Card Surg 2015; 30: 714–718. DOI 10.1111/jocs.12593.CrossRefGoogle ScholarPubMed
Cherup, LL, Siewers, RD, Futrell, JW. Breast and pectoral muscle maldevelopment after anterolateral and posterolateral thoracotomies in children. Ann Thorac Surg 1986; 41: 492–497. DOI 10.1016/s0003-4975(10)63025-1.CrossRefGoogle ScholarPubMed
Luo Z.R.Chen, Q, Yu, LL, et al. Comparative study between surgical repair of atrial septal defect via median sternotomy, right submammary thoracotomy, and right vertical ınfra-axillary thoracotomy. Braz J Cardiovasc Surg 2020; 35: 285–290. DOI 10.21470/1678-9741-2019-0096.Google Scholar
Loughry, CW, Sheffer, DB, Price, TE, et al. Breast volume measurement of 598 women using biostereometric analysis. Ann Plast Surg 1989; 22: 380–385. DOI 10.1097/00000637-198905000-00002.CrossRefGoogle ScholarPubMed
Grinda, J-M, Folliguet, TA, Dervanian, P, Lïc, M, Legault, B, Neveux, J-Y. Right anterolateral thoracotomy for repair of atrial septal defect. Ann Thorac Surg 1996; 62: 175–178. DOI 10.1016/0003-4975(96)00182-8.CrossRefGoogle ScholarPubMed
Bauer, M, Alexi-Meskishvilli, V, Nakic, Z, et al. The correction of congenital heart defects with less invasive approaches. Thorac Cardiovasc Surg 2000; 48: 67–71. DOI 10.1055/s-2000-9867.CrossRefGoogle ScholarPubMed
Taşoğlu, I, Sert, DE, Demir, A, et al. Full sternotomy with limited skin incision for surgical treatment of atrial septal defect. TurkGogus Kalp Dama 2012; 20: 705–709.CrossRefGoogle Scholar
Heinisch, PP, Wildbolz, M, Beck, MJ, et al. Vertical right axillary mini-thoracotomy for correction of ventricular septal defects and complete atrioventricular septal defects. Ann Thorac Surg 2018; 106: 1220–1227. DOI 10.1016/j.athoracsur.2018.05.003.CrossRefGoogle ScholarPubMed
Temur, B, Erek, E. Repair of ventricular septal defect and pulmonary stenosis with right lateral mini-thoracotomy. Turk Gogus Kalp Damar Cerrahisi Derg 2020; 28: 555–556. DOI 10.5606/tgkdc.dergisi.2020.19203.CrossRefGoogle ScholarPubMed
Yaliniz, H, Topcuoglu, MS, Gocen, U, et al. Comparison between minimal right vertical infra-axillary thoracotomy and standard median sternotomy for repair of atrial septal defects. Asian J Surg 2015; 38: 199–204. DOI 10.1016/j.asjsur.2015.01.008.CrossRefGoogle ScholarPubMed