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.