Methods: A full median sternotomy with mini skin incision was used in 29 patients (24 females, 5 males; median age 8 years; range 4 to 19 years) between November 2008 and August 2010. A midline chest incision was typically terminated at or near the nipple line, measuring approximately 6 cm in children and 7.5 cm in adolescents. Atrial septal defect was successfully treated through a mini skin incision in 27 patients. Skin incision was unavoidably enlarged in two patients due to technical challenges.

Results: None of the patients died and full skin incision was not performed. The mean cardiopulmonary bypass time was 57 minutes, while the mean aortic cross-clamp time was 35 minutes. The length of intensive care unit stay ranged from 1 to 2 days and the length of hospital stay ranged from 3 to 6 days (median hospital stay, 4 days). No reintervention for residual cardiac defects was required.

Conclusion: We consider that full median sternotomy with limited skin incision for the correction of atrial septal defects is safe and effective with improved cosmetic results.