Modified Right Vertical Infra-Axillary Thoracotomy Technique: A 2 to 5 cm Incision Approach for Repair of Various Congenital Heart Diseases in All Age Groups

OBJECTIVE: To evaluate the surgical outcomes of the modified right vertical infra-axillary thoracotomy (MRVIAT) technique for the treatment of various congenital heart diseases (CHDs) across all age groups. METHODS: A retrospective analysis was performed on 1,513 patients with CHD who underwent surgery using the MRVIAT technique between January 2022 and June 2024. Incisions were 2 to 5 cm, and peripheral extracorporeal circulation was not used. Twelve primary surgical procedures were executed across all age groups. RESULTS: All 1,513 patients successfully underwent surgery without the need for conversion to a median sternotomy or any in-hospital mortality. The median patient age was 1.1 years (range, 0.1 to 57 years), with 62 patients aged 18 years or older. The median weight was 9 kg (range, 1.8 to 101.6 kg), with 859 patients (56.8%) weighing ≤10 kg, 588 patients (39.9%) weighing between 10 kg and 50 kg, and 66 patients (4.4%) weighing ≥50 kg. Two patients (0.1%) required early reoperation: 1 (0.1%) due to third-degree atrioventricular block and 1 (0.1%) due to postoperative bleeding. Other postoperative complications included mild residual shunt in 20 patients (1.3%), pneumothorax in 2 patients (0.1%), wound infection in 3 patients (0.2%), and pulmonary infection in 4 patients (0.3%). The median follow-up period was 1.3 years (range, 0.3 to 2.5 years). During follow-up, no surgery-related thoracic deformities were noted. CONCLUSIONS: The MRVIAT technique is a safe and viable method for treating CHD patients across all age groups. This technique, which involves a smaller, less prominent incision, offers a promising alternative to median sternotomy methods.