{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T06:25:04Z","timestamp":1793255104549,"version":"4.5.0"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2020,8,16]],"date-time":"2020-08-16T00:00:00Z","timestamp":1597536000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p\/>\n                  <jats:p>We aimed to investigate the safety, feasibility and early and mid-term outcomes of total repair of elective tetralogy of Fallot through a right subaxillary thoracotomy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Between May 2010 and September 2015, a retrospective review of patients with elective tetralogy of Fallot undergoing primary repair through a right subaxillary thoracotomy was performed. This study included 47 patients [27 males, 20 females; the mean age of 1.7\u2009\u00b1\u20091.5\u2009years (ranging from 3 to 106\u2009months); body weight of 9.7\u2009\u00b1\u20092.8\u2009kg (ranging from 5 to 16\u2009kg); McGoon ratio \u22651.5]. The ventricular septal defects were approached through a right atriotomy in 30 patients, a right ventriculotomy in 8 patients and the combination of a right atriotomy and ventriculotomy in 9 patients. Transannular and non-transannular patches were used in 20 and 27 patients, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>There was 1 operative death (2.1%), and the others recovered uneventfully. The median cardiopulmonary bypass and aortic cross-clamping times was 79\u2009\u00b1\u200920.8 (45\u2013136) and 50\u2009\u00b1\u200915.7 (25\u201394) min, respectively. The mechanical ventilation time, length of intensive care unit and postoperative hospital stay were 0.9\u2009\u00b1\u20090.6, 2.6\u2009\u00b1\u20091.1 and 10.7\u2009\u00b1\u20092.7\u2009days, respectively. The main complications involved low cardiac output syndrome in 5 patients, arrhythmia in 6 patients, pulmonary infection in 4 patients, small residual shunt in 2 patients, mild residual right ventricular outflow tract obstruction in 2 patients, mild tricuspid regurgitation in 3 patients and atelectasis in 1 patient. The mean follow-up time was 82\u2009\u00b1\u200922.0\u2009months, and no late deaths occurred during the follow-up. One (2.1%) patient received reintervention for residual significant pulmonary artery stenosis. That was in addition to 2 (4.3%) patients having mild residual right ventricular outflow tract, 1 (2.1%) patient with moderate tricuspid regurgitation and 3 (6.4%) patients with moderate pulmonary valve regurgitation to be followed up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>The right subaxillary thoracotomy, providing a safe and feasible alternative, can be performed with a low mortality rate and satisfactory early and mid-term outcomes for total repair of elective tetralogy of Fallot.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezaa210","type":"journal-article","created":{"date-parts":[[2020,5,20]],"date-time":"2020-05-20T19:10:41Z","timestamp":1590001841000},"page":"969-974","source":"Crossref","is-referenced-by-count":7,"title":["Early and mid-term outcomes of total repair of tetralogy of Fallot through a right subaxillary thoracotomy"],"prefix":"10.1093","volume":"58","author":[{"given":"Guoying","family":"An","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Shandong Provincial Key Laboratory of Cardiac Disease Diagnosis and Treatment, Affiliated Hospital of Jining Medical University, Jining, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiwei","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Shandong Provincial Key Laboratory of Cardiac Disease Diagnosis and Treatment, Affiliated Hospital of Jining Medical University, Jining, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanguang","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Shandong Provincial Key Laboratory of Cardiac Disease Diagnosis and Treatment, Affiliated Hospital of Jining Medical University, Jining, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weixin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Shandong Provincial Key Laboratory of Cardiac Disease Diagnosis and Treatment, Affiliated Hospital of Jining Medical University, Jining, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Shandong Provincial Key Laboratory of Cardiac Disease Diagnosis and Treatment, Affiliated Hospital of Jining Medical University, Jining, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Shandong Provincial Key Laboratory of Cardiac Disease Diagnosis and Treatment, Affiliated Hospital of Jining Medical University, Jining, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianjin","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Shandong Provincial Key Laboratory of Cardiac Disease Diagnosis and Treatment, Affiliated Hospital of Jining Medical University, Jining, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,8,16]]},"reference":[{"key":"2020102110254692300_ezaa210-B1","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/j.hlc.2017.01.014","article-title":"Evaluation of different minimally invasive techniques in surgical treatment for ventricular septal defect","volume":"27","author":"Liu","year":"2018","journal-title":"Heart Lung Circ"},{"key":"2020102110254692300_ezaa210-B2","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1007\/s00246-019-02144-w","article-title":"Through tricuspid closure for doubly committed subarterial ventricular septal defect with right vertical subaxillary mini-incision: a matched-pair analysis","volume":"40","author":"Liu","year":"2019","journal-title":"Pediatr Cardiol"},{"key":"2020102110254692300_ezaa210-B3","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/s13019-018-0734-5","article-title":"Surgical repair via submammary thoracotomy, right axillary thoracotomy and median sternotomy for ventricular septal defects","volume":"13","author":"Hong","year":"2018","journal-title":"J Cardiothorac Surg"},{"key":"2020102110254692300_ezaa210-B4","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1016\/j.hlc.2015.02.010","article-title":"Safety and efficacy of ventricular septal defect repair using a cosmetic shorter right lateral thoracotomy on infants weighing less than 5 kg","volume":"24","author":"Li","year":"2015","journal-title":"Heart Lung 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Recent experience using a prospective protocol","volume":"31","author":"Villani","year":"1983","journal-title":"Thorac Cardiovasc Surg"},{"key":"2020102110254692300_ezaa210-B15","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1111\/chd.12205","article-title":"Risk factors associated with prolonged mechanical ventilation after corrective surgery for tetralogy of Fallot","volume":"10","author":"Li","year":"2015","journal-title":"Congenit Heart Dis"},{"key":"2020102110254692300_ezaa210-B16","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1016\/j.jtcvs.2013.03.033","article-title":"Results of elective repair at 6 months or younger in 277 patients with tetralogy of Fallot: a 14-year experience at a single center","volume":"147","author":"Kirsch","year":"2014","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2020102110254692300_ezaa210-B17","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1016\/j.athoracsur.2016.02.087","article-title":"Influence of age and weight on technical repair of tetralogy of Fallot","volume":"102","author":"Cunningham","year":"2016","journal-title":"Ann Thorac Surg"},{"key":"2020102110254692300_ezaa210-B18","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1016\/j.athoracsur.2016.07.020","article-title":"Optimal timing for elective early primary repair of tetralogy of Fallot: analysis of intermediate term outcomes","volume":"103","author":"Cunningham","year":"2017","journal-title":"Ann Thorac Surg"},{"key":"2020102110254692300_ezaa210-B19","doi-asserted-by":"publisher","DOI":"10.1002\/ajhb.22918","article-title":"Intergenerational changes in chest size and proportions in children and adolescents aged 3-18 from Krak\u00f3w (Poland), within the last 70 years","volume":"29","author":"Kryst","year":"2017","journal-title":"Am J Hum Biol"}],"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ejcts\/article-pdf\/58\/5\/969\/33976677\/ezaa210.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ejcts\/article-pdf\/58\/5\/969\/33976677\/ezaa210.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,10,21]],"date-time":"2020-10-21T14:28:44Z","timestamp":1603290524000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/58\/5\/969\/5892997"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,16]]},"references-count":19,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2020,8,16]]},"published-print":{"date-parts":[[2020,11,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezaa210","relation":{},"ISSN":["1010-7940","1873-734X"],"issn-type":[{"value":"1010-7940","type":"print"},{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,11]]},"published":{"date-parts":[[2020,8,16]]}}}