ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Patient perception, satisfaction and cosmetic results of surgical atrial septal defect closure: Minithoracotomy versus sternotomy
Mehmet Kaya1, Sevin Özgül Gülbeyaz2, Okan Yıldız1, Gözde Uyanık3, Hüsnü Fırat Altın1, Özgen Ilgaz Koçyiğit4, Ahmet İrdem5, Ersin Erek1
1Departments of Cardiovascular Surgery, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
2Departments of Plastic, Reconstructive and Aesthetic Surgery, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
3Departments of Psychology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
4Departments of Anaesthesiology and Reanimation İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
5Departments of Pediatric Cardiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
DOI : 10.5606/tgkdc.dergisi.2015.10473
Background: This study aims to compare two surgical techniques [right lateral minithoracotomy (RLMT) and median sternotomy (MS)] used to close atrial septal defects (ASD), and measure patient satisfaction, cosmetic results, and patient perception with tests used for evaluating scar and mental status.

Methods: A total of 26 ASD patients were included in the study, of which 14 were operated with the MS method (group MS), and 12 were operated with the RLMT method (group RLMT). Patients were divided into two groups according to the incision sites. Patients’ incision scars were assessed objectively according to Vancouver Scar Scale (VSS), and Patient and Observer Scar Assessment (POSAS) criteria. Besides, patients were administered Patient Satisfaction Score (PSS), Body Image Questionnaire (BIQ), and The Hamilton Anxiety Rating Scale (HAM-A) to measure their perception.

Results: Overall patient satisfaction was greater in the RLMT group than the MS group (p=0.021). There was no significant difference between the two groups in terms of VSS, BIQ, HAM-A, and skin type. Average scar length (p<0.0001), cardiopulmonary bypass time (p=0.016), and duration of hospital stay (p=0.019) were shorter in patients who were performed RLMT than those who were performed MS.

Conclusion: Our study revealed that patients who were performed RLMT were more satisfied with their scar result. Although scar features of patients may be similar, incision site may depend on the decisions of patients who do not prefer to reveal having undergone a surgical intervention to their chest. Right lateral minithoracotomy also reduces the length of hospital stay. Our findings may contribute to further research on the most appropriate surgical technique for ASD closure.

Keywords : Atrial septal defect; cosmetic results; incision cite; patient satisfaction
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