Comparative Clinical Outcomes of Right Lateral Thoracotomy and Totally Thoracoscopic Surgery for Adult Patients with Atrial Septal Defect: A Single Center, Retrospective Study

Background: Totally thoracoscopic surgery (TTS) and right lateral thoracotomy (RLT) are both extensively utilized in the surgical repair for atrial septal defect (ASD). However, RLT is generally considered in low-weight pediatric patients as a result of restricted surgical exposure. This study aims to introduce an RLT approach for ASD repair in adults and compare its clinical outcomes with TTS. Methods: We conducted a retrospective analysis of the clinical data of 23 adult patients who underwent ASD repair at Guangdong Provincial People’s Hospital between June and October 2024. Patients were divided into two groups based on the surgical approach they adopted: group totally thoracoscopic surgery (TTS, n = 12) and group right lateral thoracotomy (RLT, n = 11). All individuals finished a follow-up three months after surgery. Operative parameters, postoperative courses, echocardiographic measurements and laboratory investigations were compared between the two groups. Results: The total surgical duration was significantly longer in group RLT compared with group TTS [(234.00 ± 47.93) min vs. (175.17 ± 52.36) min, p = 0.011]. Group RLT exhibited a significantly higher respiratory index (RI) at