Background: The closure of atrial septal defect via sternotomy is a standart procedure performed with low risk. Right anterior thoracotomy is an alternative approach by needs of cosmetic aspects in female patients. We aimed to evaluate safety of the procedure, clinical results and patients’ satisfaction for minithoracotomy cases that are performed in our clinic with regards to cosmetic aspects of female patients.

Methods: Between the years 1996 and 2003 perioperative and long term follow up (mean follow-up time:40.6 months) of 40 female patients (with mean age 25.4) operated in our clinic for all types of atrial septal defects were analysed retrospectively. Special futures of the operation technique consisted of limited skin incision, protection of mammarian gland, prevention of phrenic nerve injury.

Results: Conversion to sternotomy was needed in one patient because of inappropriate exploration. Rethoracotomy was performed in one patient because of postoperative bleeding. Two patients needed analgesic medication for intercostal neuralgia. Mean hospital stay was 4.06 days. Mitral valve incompetance was present in one patient. In respect to interviews cosmetic satisfaction was achieved in 91.2% of patients and remaining 6.7% was undecided. Two patients complainted of wide scar formation in incision line. Breast asymetry was exsisted in 3 patients. In summary none of the interviewed patients would have prefered sternotomy in operation technique.

Conclusion: Right anterior minithoracotomy in closure of atrial septal defects in regards to cosmetic aspects would be prefered especially in female patients with reliable results and high patient satisfaction.

Keywords : Anterior thoracotomy, atrial septal defect, patient satisfaction