Abstract
BackgroundAnterolateral Minithoracotomy (ALMT) for the radical correction of Congenital Heart Defects is an alternative to Median Sternotomy (MS) due to reduce operative trauma accelerating recovery and yield a better cosmetic outcome after surgery. Our purpose is to conduct whether ALMT would bring more short-term benefits to patients than conventional Median Sternotomy by using a meta-analysis of case–control study in the published English Journal.Methods6 case control studies published in English from 1997 to 2011 were identified and synthesized to compare the short-term postoperative outcomes between ALMT and MS. These outcomes were cardiopulmonary bypass time, aortic cross-clamp time, intubation time, intensive care unit stay time, and postoperative hospital stay time.ResultsALMT had significantly longer cardiopulmonary bypass times (8.00 min more, 95% CI 0.36 to 15.64 min, p = 0.04). Some evidence proved that aortic cross-clamp time of ALMT was longer, yet not significantly (2.38 min more, 95% CI −0.15 to 4.91 min, p = 0.06). In addition, ALMT had significantly shorter intubation time (1.66 hrs less, 95% CI −3.05 to −0.27 hrs, p = 0.02). Postoperative hospital stay time was significantly shorter with ALMT (1.52 days less, 95% CI −2.71 to −0.33 days, p = 0.01). Some evidence suggested a reduction in ICU stay time in the ALMT group. However, this did not prove to be statistically significant (0.88 days less, 95% CI −0.81 to 0.04 days, p = 0.08).ConclusionALMT can bring more benefits to patients with Congenital Heart Defects by reducing intubation time and postoperative hospital stay time, though ALMT has longer CPB time and aortic cross-clamp time.
Highlights
Anterolateral Minithoracotomy (ALMT) for the radical correction of Congenital Heart Defects is an alternative to Median Sternotomy (MS) due to reduce operative trauma accelerating recovery and yield a better cosmetic outcome after surgery
We found 30 studies, in which 6 studies met our criteria. 932 patients were included (384 Atrial Septal Defect, 85 Ventricular Septal Defect, 13 Partial Anomalous Pulmonary Venous Connection, 15 Partial Atrioventricular Canal, 3 Tetralogy of Fallot, 3 Cor Triatriatum, 12 Congenital Mitral Valve Defect, 2 Pericardial Cysts, 415 in the control group not mentioned), on operation interventions 263 undergoing ALMT and 669 MS
The ALMT group had a significant longer cardiopulmonary bypass (CPB) time (8.00 min more, 95% CI 0.36 to 15.64 min, p = 0.04)
Summary
Anterolateral Minithoracotomy (ALMT) for the radical correction of Congenital Heart Defects is an alternative to Median Sternotomy (MS) due to reduce operative trauma accelerating recovery and yield a better cosmetic outcome after surgery. Our purpose is to conduct whether ALMT would bring more short-term benefits to patients than conventional Median Sternotomy by using a meta-analysis of case–control study in the published English Journal. The Anterolateral Minithoracotomy (ALMT) is a cardiovascular surgery technique in the purpose of reducing the surgical trauma so that to accelerate recovery and promote the cosmetic outcome, especially for the young female [1]. Some illustrate the long-term outcome measures in the ALMT group comparing with the MS group [8].
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