ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Pediatric Cardiology
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1457554
Prognostic analysis of children with tetralogy of Fallot through a small incision in the right axilla
Provisionally accepted
- Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: Compare the clinical efficacy of a minimally invasive small incision in the right axilla versus traditional median sternotomy in the surgical treatment of Tetralogy of Fallot. Methods: A retrospective analysis was conducted on 330 infants and young children under the age of 3 who underwent radical surgery for Tetralogy of Fallot between March 2022 and March 2024. Patients were categorized into two groups based on the surgical approach. To ensure the consistency of preoperative baseline data (weight, gender, age,O2 saturation,main pulmonary artery and pulmonary branches diameter,Mcgoon ratio) between the two groups, propensity score matching method was applied for 1:1 matching, resulting in two cohorts of 228 cases.The minimally invasive group (n = 114) received surgery through a small incision in the right axilla, while the median sternotomy group (n = 114) underwent surgery via median sternotomy. Clinical parameters including demographic data (weight, gender, age,O2 saturation,main pulmonary artery and pulmonary branches diameter,Mcgoon ratio ), cardiopulmonary bypass metrics (duration of bypass, aortic cross-clamp time), duration of mechanical ventilation, ICU stay, postoperative chest drainage volume within 24 hours, pulmonary valve regurgitation and complications (reintubation, peritoneal dialysis,re-operation, ECMO use, infection, and mortality) were collected for comparison between groups. Results: No statistically significant differences were observed between the two groups in 24-hour chest drainage volume, mortality, reintubation, re-operation,ECMO use, and infection. However, the minimally invasive group showed significantly shorter ventilator duration and ICU stay, and a reduced rate of peritoneal dialysis (all p < 0.05). Conclusion: In infants and children under 3 years old with TOF, surgical correction via a right axillary small incision achieves equivalent clinical outcomes to traditional median sternotomy, without increasing postoperative mortality or complication rates. Additionally, the minimally invasive approach offers benefits of reduced surgical trauma and enhanced postoperative recovery.
Keywords: minimally invasive surgery, Tetralogy of Fallot, Right subaxillary vertical thoracotomy, Cardiopulmonary Bypass, Median sternotomy incision
Received: 01 Jul 2024; Accepted: 13 Jun 2025.
Copyright: © 2025 Meng, li, liang, dong and li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: wei jie liang, Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.