{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T23:26:00Z","timestamp":1786922760300,"version":"build-2736575974"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":68,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cardiothorac Surg"],"DOI":"10.1186\/s13019-026-04401-5","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T12:16:30Z","timestamp":1781093790000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A comparative study of surgical repair of large atrial septal defects in adults using inferior mini-sternotomy and right axillary vertical mini-incision"],"prefix":"10.1186","volume":"21","author":[{"given":"ChunZhu","family":"Xue","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"XianZhi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"CHen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"CunFu","family":"Mu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"4401_CR1","unstructured":"Amabile A, DegifeE, Krane M, LaLonde MR, Gruber PJ, Geirsson A. Robotic, totally endoscopic atrial septal defect repair.[J]. Multimedia manual of cardiothoracic surgery: MMCTS, 2021, 2021."},{"issue":"28","key":"4401_CR2","doi-asserted-by":"publisher","first-page":"2660","DOI":"10.1093\/eurheartj\/ehab646","volume":"43","author":"M Brida","year":"2022","unstructured":"Brida M, Chessa M, Celermajer D, Li W, Geva T, Khairy P, Griselli M, Baumgartner H, Gatzoulis MA. Atrial septal defect in adulthood: a new paradigm for congenital heart disease.[J]. Eur Heart J. 2022;43(28):2660\u201371.","journal-title":"Eur Heart J"},{"issue":"Suppl 24","key":"4401_CR3","doi-asserted-by":"publisher","first-page":"S2923","DOI":"10.21037\/jtd.2018.07.128","volume":"10","author":"A Faccini","year":"2018","unstructured":"Faccini A, Butera G. Atrial septal defect (ASD) device trans-catheter closure: limitations.[J]. J Thorac disease. 2018;10(Suppl 24):S2923\u201330.","journal-title":"J Thorac disease"},{"issue":"2","key":"4401_CR4","doi-asserted-by":"publisher","first-page":"90","DOI":"10.14740\/cr699w","volume":"9","author":"F Sabzi","year":"2018","unstructured":"Sabzi F, Faraji R, Kazeminasab M. Minimal Invasive Technique in Atrial Septal Defect Surgery.[J]. Cardiol Res. 2018;9(2):90\u20133.","journal-title":"Cardiol Res"},{"issue":"10","key":"4401_CR5","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1097\/EJA.0000000000001881","volume":"40","author":"T Mae\u00dfen","year":"2023","unstructured":"Mae\u00dfen T, Korir N, Van de Velde M, Kennes J, Pogatzki-Zahn E, Joshi GP. Pain management after cardiac surgery via median sternotomy: A systematic review with procedure-specific postoperative pain management (PROSPECT) recommendations.[J]. Eur J Anaesthesiol. 2023;40(10):758\u201368.","journal-title":"Eur J Anaesthesiol"},{"key":"4401_CR6","doi-asserted-by":"crossref","unstructured":"El-Andari R, Watkins AR, Fialka NM, AlAklabi AM, Kang JJH, Bozso SJ, Jonker D, Freed DH, AlAklabi M, Bouchard D, Chu MWA, Moon MC, Nagendran J. A Systematic Review of Minimally Invasive Approaches to Surgical Atrial Septal Defect Repair.[J]. Heart Lung Circ. 2025;34(8):764\u201376.","DOI":"10.1016\/j.hlc.2025.01.010"},{"issue":"9","key":"4401_CR7","doi-asserted-by":"publisher","first-page":"e98","DOI":"10.1016\/j.hlc.2021.03.270","volume":"30","author":"IE Konstantinov","year":"2021","unstructured":"Konstantinov IE, Buratto E. Atrial Septal Defect Closure via Ministernotomy in Children.[J]. Heart Lung Circ. 2021;30(9):e98\u2013100.","journal-title":"Heart Lung Circ"},{"issue":"4","key":"4401_CR8","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1016\/j.asjsur.2015.01.008","volume":"38","author":"H Yaliniz","year":"2015","unstructured":"Yaliniz H, Topcuoglu MS, Gocen U, Atalay A, Keklik V, Basturk Y, Gunes Y, Turktan M, Salih OK. Comparison between minimal right vertical infra-axillary thoracotomy and standard median sternotomy for repair of atrial septal defects.[J]. Asian J Surg. 2015;38(4):199\u2013204.","journal-title":"Asian J Surg"},{"issue":"1","key":"4401_CR9","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1186\/s13019-022-01999-0","volume":"17","author":"X Yang","year":"2022","unstructured":"Yang X, Hu Y, Dong J, Huang P, Luo J, Yang G, Deng X. Rightvertical axillary incision for atrial septal defect: a propensity score matched study.[J]. J Cardiothorac Surg. 2022;17(1):256.","journal-title":"J Cardiothorac Surg"},{"issue":"1","key":"4401_CR10","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1111\/jocs.15160","volume":"36","author":"A\u00dc G\u00fcll\u00fc","year":"2021","unstructured":"G\u00fcll\u00fc A\u00dc, \u015eenay \u015e, Ersin E, Demirhisar \u00d6, Whitham T, Ko\u00e7yi\u011fit M, Alhan C. Robotic-assisted cardiac surgery without aortic cross-clamping: A safe alternative approach.[J]. J Card Surg. 2021;36(1):165\u20138.","journal-title":"J Card Surg"},{"issue":"6","key":"4401_CR11","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1093\/eurheartj\/ehaa554","volume":"42","author":"H Baumgartner","year":"2021","unstructured":"Baumgartner H, De Backer J, Babu-Narayan SV, Budts W, Chessa M, Diller G, Lung B, Kluin J, Lang IM, Meijboom F, Moons P, Mulder BJM, Oechslin E, Roos-Hesselink JW, Schwerzmann M, Sondergaard L, Zeppenfeld K. 2020 ESC Guidelines for the management of adult congenital heart disease.[J]. Eur Heart J. 2021;42(6):563\u2013645.","journal-title":"Eur Heart J"},{"issue":"6","key":"4401_CR12","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1080\/14779072.2020.1767595","volume":"18","author":"W Alkashkari","year":"2020","unstructured":"Alkashkari W, Albugami S, Hijazi ZM. Current practice in atrial septal defect occlusion in children and adults.[J]. Expert Rev Cardiovasc Ther. 2020;18(6):315\u201329.","journal-title":"Expert Rev Cardiovasc Ther"},{"issue":"4","key":"4401_CR13","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1007\/s00395-024-01062-0","volume":"119","author":"SA Sabe","year":"2024","unstructured":"Sabe SA, Harris DD, Broadwin M, Sellke FW. Cardioprotection in cardiovascular surgery.[J]. Basic Res Cardiol. 2024;119(4):545\u201368.","journal-title":"Basic Res Cardiol"},{"issue":"14","key":"4401_CR14","doi-asserted-by":"publisher","first-page":"e193","DOI":"10.1161\/CIR.0000000000000885","volume":"142","author":"M Gaudino","year":"2020","unstructured":"Gaudino M, Benesch C, Bakaeen F, DeAnda A, Fremes SE, Glance L, Mess\u00e9 SR, Pandey A, Rong LQ. Considerations for Reduction of Risk of Perioperative Stroke in Adult Patients Undergoing Cardiac and Thoracic Aortic Operations: A Scientific Statement From the American Heart Association.[J]. Circulation. 2020;142(14):e193\u2013209.","journal-title":"Circulation"},{"key":"4401_CR15","doi-asserted-by":"publisher","first-page":"1424188","DOI":"10.3389\/fmed.2024.1424188","volume":"11","author":"P Chiari","year":"2024","unstructured":"Chiari P, Fellahi J. Myocardial protection in cardiac surgery: a comprehensive review of current therapies and future cardioprotective strategies.[J]. Front Med. 2024;11:1424188.","journal-title":"Front Med"},{"issue":"1","key":"4401_CR16","doi-asserted-by":"publisher","first-page":"55","DOI":"10.5090\/jcs.21.111","volume":"55","author":"T Yun","year":"2022","unstructured":"Yun T, Kim H, Sohn B, Chang HW, Lim C, Park K. Robot-Assisted Repair of Atrial Septal Defect: A Comparison of Beating and Non-Beating Heart Surgery.[J]. J chest Surg. 2022;55(1):55\u201360.","journal-title":"J chest Surg"},{"issue":"12","key":"4401_CR17","doi-asserted-by":"publisher","first-page":"6557","DOI":"10.21037\/jtd.2018.10.89","volume":"10","author":"Y Tang","year":"2018","unstructured":"Tang Y, Wu Y, Zhu J, Liu X, Zhou J, Huang H, Li M, Dai Y, Han X. Total endoscopic repair of atrial septal defect under on-pump beating heart.[J]. J Thorac disease. 2018;10(12):6557\u201362.","journal-title":"J Thorac disease"},{"issue":"1","key":"4401_CR18","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1007\/s00464-024-11356-y","volume":"39","author":"X Wang","year":"2025","unstructured":"Wang X, Sun H, Ma B, Liu K, Ma Z. Thoracoscopic closure of atrial septal defect in perfused beating hearts[J]. Surg Endosc. 2025;39(1):341\u20138.","journal-title":"Surg Endosc"},{"key":"4401_CR19","doi-asserted-by":"crossref","unstructured":"Dang Q, Le N, Nguyen C, Tran D, Nguyen D, Nguyen T, Ngo T. Totally Endoscopic Cardiac Surgery for Atrial Septal Defect Repair on Beating Heart Without Robotic Assistance in 25 Patients.[J]. Innovations (Philadelphia, Pa.), 2017, 12(6): 446\u2013452.","DOI":"10.1097\/imi.0000000000000436"},{"issue":"3","key":"4401_CR20","doi-asserted-by":"publisher","first-page":"285","DOI":"10.21470\/1678-9741-2019-0096","volume":"35","author":"Z Luo","year":"2020","unstructured":"Luo Z, Chen Q, Yu L, Chen L, Huang Z. Comparative Study between Surgical Repair of Atrial Septal Defect via Median Sternotomy, Right Submammary Thoracotomy, and Right Vertical Infra-Axillary Thoracotomy.[J]. Brazilian J Cardiovasc Surg. 2020;35(3):285\u201390.","journal-title":"Brazilian J Cardiovasc Surg"},{"issue":"5","key":"4401_CR21","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1007\/s00246-020-02341-y","volume":"41","author":"KS Mylonas","year":"2020","unstructured":"Mylonas KS, Ziogas IA, Evangeliou A, Hemmati P, Schizas D, Sfyridis PG, Economopoulos KP, Bakoyiannis C, Kapelouzou A, Tzifa A, Avgerinos DV. Minimally Invasive Surgery vs Device Closure for Atrial Septal Defects: A Systematic Review and Meta-analysis.[J]. Pediatr Cardiol. 2020;41(5):853\u201361.","journal-title":"Pediatr Cardiol"},{"issue":"1","key":"4401_CR22","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1186\/s13019-020-01294-w","volume":"15","author":"L Huang","year":"2020","unstructured":"Huang L, Chen D, Chen L, Xu Q, Zheng Z, Dai X. The use of the Scar Cosmesis Assessment and rating scale to evaluate the cosmetic outcomes of totally thoracoscopic cardiac surgery.[J]. J Cardiothorac Surg. 2020;15(1):250.","journal-title":"J Cardiothorac Surg"},{"issue":"1346","key":"4401_CR23","first-page":"57","volume":"124","author":"H Jina","year":"2011","unstructured":"Jina H, Simcock J. Median sternotomy scar assessment.[J]. N Z Med J. 2011;124(1346):57\u201362.","journal-title":"N Z Med J"},{"key":"4401_CR24","doi-asserted-by":"crossref","unstructured":"An K, Li S, Yan J, Wang X, Hua Z. Minimal Right Vertical Infra-axillary Incision for Repair of Congenital Heart Defects.[J]. Ann Thorac Surg. 2022;113(3):896\u2013902.","DOI":"10.1016\/j.athoracsur.2021.01.052"},{"issue":"1","key":"4401_CR25","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1017\/S1047951122000117","volume":"33","author":"J Dodge-Khatami","year":"2023","unstructured":"Dodge-Khatami J, Noor R, Riggs KW, Dodge-Khatami A. Mini right axillary thoracotomy for congenital heart defect repair can become a safe surgical routine.[J]. Cardiol Young. 2023;33(1):38\u201341.","journal-title":"Cardiol Young"},{"issue":"5","key":"4401_CR26","doi-asserted-by":"publisher","first-page":"3422","DOI":"10.21037\/jtd-24-158","volume":"16","author":"T Miyazaki","year":"2024","unstructured":"Miyazaki T, Doi R, Matsumoto K. Post-thoracotomy pain syndrome in the era of minimally invasive thoracic surgery.[J]. J Thorac disease. 2024;16(5):3422\u201330.","journal-title":"J Thorac disease"},{"issue":"11","key":"4401_CR27","doi-asserted-by":"publisher","first-page":"1022","DOI":"10.23736\/S0375-9393.23.17291-9","volume":"89","author":"S Feray","year":"2023","unstructured":"Feray S, Lemoine A, Aveline C, Quesnel C. Pain management after thoracic surgery or chest trauma.[J]. Minerva Anestesiol. 2023;89(11):1022\u201333.","journal-title":"Minerva Anestesiol"},{"issue":"11","key":"4401_CR28","doi-asserted-by":"publisher","first-page":"416","DOI":"10.1016\/j.bjae.2023.07.001","volume":"23","author":"M Patel","year":"2023","unstructured":"Patel M, Wilson A, Ong C. Double-lumen tubes and bronchial blockers.[J]. BJA Educ. 2023;23(11):416\u201324.","journal-title":"BJA Educ"},{"issue":"7","key":"4401_CR29","doi-asserted-by":"publisher","first-page":"5371","DOI":"10.21037\/jtd-2025-314","volume":"17","author":"Y Sha","year":"2025","unstructured":"Sha Y, Xu R, Shao S, Yang J, Tang B, Liang Q, Wang Z. Tailored single-lung ventilation approaches and postoperative pulmonary outcomes in thoracic surgery.[J]. J Thorac disease. 2025;17(7):5371\u201387.","journal-title":"J Thorac disease"},{"key":"4401_CR30","doi-asserted-by":"crossref","unstructured":"Minaev AV, Mironenko MY, Dontsova VI, Pirushkina YD, Berdibekov BS, Voynov AS, Sarkisyan JA, Golukhova EZ. Left Atrial Structural and Functional Changes in Adults with Congenital Septal Defects and Paroxysmal Atrial Fibrillation.[J]. Journal of clinical medicine, 2024, 13(19).","DOI":"10.3390\/jcm13196023"},{"issue":"1","key":"4401_CR31","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1186\/s13019-018-0734-5","volume":"13","author":"Z Hong","year":"2018","unstructured":"Hong Z, Chen Q, Lin Z, Zhang G, Chen L, Zhang Q, Cao H. Surgical repair via submammary thoracotomy, right axillary thoracotomy and median sternotomy for ventricular septal defects.[J]. J Cardiothorac Surg. 2018;13(1):47.","journal-title":"J Cardiothorac Surg"},{"key":"4401_CR32","doi-asserted-by":"crossref","unstructured":"Hardman G, Zacharias J. Minimal-Access Atrial Septal Defect (ASD) Closure.[J]. J Cardiovasc Dev disease, 2023;10(5):205.","DOI":"10.3390\/jcdd10050206"}],"container-title":["Journal of Cardiothoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13019-026-04401-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-026-04401-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-026-04401-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T23:19:46Z","timestamp":1786922386000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s13019-026-04401-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,10]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4401"],"URL":"https:\/\/doi.org\/10.1186\/s13019-026-04401-5","relation":{},"ISSN":["1749-8090"],"issn-type":[{"value":"1749-8090","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,10]]},"assertion":[{"value":"16 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The research reported had adhered to the relevant ethical guidelines.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent was obtained from the patient for publication of this study and accompanying images.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no conflicts of interest to disclose.","order":4,"name":"Ethics","label":"Conflicts of interest\/Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"583"}}