Mini-thoracotomy versus median sternotomy for atrial septal defect closure: Should mini-thoracotomy be applied as a standard technique?

Background: This study aims to compare outcomes of minithoracotomy versus median sternotomy for atrial septal defect closure. Methods: Between January 2012 and May 2017, a total of 44 patients (8 males, 36 females; mean age 33.86 years; range, 14 to 63 years) who underwent atrial septal defect repair through mini-thoracotomy or median sternotomy in our clinic were retrospectively analyzed. Pre-, intra-, and postoperative data of the patients were recorded. Results: There was no significant difference in the cardiopulmonary bypass and cross-clamp times between the groups, although the duration of operation was shorter in the mini-thoracotomy group (p=0.001). No significant difference was observed between the groups in terms of early mortality, neurological complications, and residual atrial septal defect. The mean mechanical ventilation time and length of intensive care unit and hospital stay were statistically significantly shorter, and the amount of bleeding was statistically significantly lower in the mini-thoracotomy group (p=0.001 for all). Conclusion: Mini-thoracotomy should be kept in mind as a favorable alternative to sternotomy following a satisfactory learning curve period with less cost and higher patient benefit.