Methods: A total of 148 patients (93 females, 55 males; mean age 15.7 years; range 1.5 to 50 years) underwent atrial septal defect closure via right mini-thoracotomy between January 2013 and June 2016. Right mini-thoracotomy incision localization was determined according to patients’ age and gender. Central aortic and bicaval cannulation was performed in all the patients. The mean length of the skin incision was 5±1 cm in the patients under 13 years of age and 6±1.5 cm in the patients over 13 years of age and 7.5 cm in adolescents. Atrial septal defects were successfully closed through a right mini-thoracotomy in all patients (3 tricuspid regurgitation, 17 partial anomalous pulmonary venous connection, and, 2 Scimitar syndrome).

Results: Mortality was seen in none of the patients. No intraoperative urgent sternotomy or femoral cannulation was required. The mean cardiopulmonary bypass time was 38±8.2 min, while the mean aortic cross-clamp time was 16±3.8 min and the mean time of surgery was 124±11.3 min. The mean intensive care unit stay was 22 hours and duration of hospital stay was 4 to 6 days. Hemodynamically non-significant residual atrial septal defects were detected on echocardiography in four patients (3.25%).

Conclusion: We consider that right mini-thoracotomy with submammary skin incision for the correction of atrial septal defects is a safe and effective technique with improved cosmetic results.