Surgical patch closure of atrial septal defects

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Presentation transcript:

Surgical patch closure of atrial septal defects Richard A Hopkins, MD, Arthur A Bert, MD, Bryan Buchholz, CCP, MS, Kathleen Guarino, BSN, PNP, Merry Meyers, MS The Annals of Thoracic Surgery Volume 77, Issue 6, Pages 2144-2149 (June 2004) DOI: 10.1016/j.athoracsur.2003.10.105

Fig 1 Age distribution (pediatric and adult patients, 1988 to 2002) demonstrates a bimodality reflecting the clinical practice of pediatric cases being performed primarily before attaining school age and adults being operated on at the time of discovery. The Annals of Thoracic Surgery 2004 77, 2144-2149DOI: (10.1016/j.athoracsur.2003.10.105)

Fig 2 The series of photographs demonstrate incisions after closure of secundum atrial septal defect utilizing the adult female surgical aproach as described in the methods. (A) Incision five days after surgery. Submammary incision is placed on the underside of the breast as opposed to the crease to avoid discomfort from underclothes, but as the incision is deepened transgressing breast tissue is avoided and the breast is lifted off of the rib cage for approximately 3 cm for entry into the chest, either intercostal or through the bed of resected rib. (B) Same patient, one year after ASD closure. (C) Her index finger points to the groin incision used for cardiopulmonary bypass cannulation. (D) Oblique view of same patient; bikini line incisions are not visible. The only visible reminders of surgery are the chest tube exit sites. Soft drainage catheters (Blake drains) further reduce skin scarring at “chest tube sites” and our method has subsequently been modified to avoid rigid chest tubes to enhance the cosmetic benefits. The Annals of Thoracic Surgery 2004 77, 2144-2149DOI: (10.1016/j.athoracsur.2003.10.105)