Thorac Cardiovasc Surg 2005; 53(2): 93-95
DOI: 10.1055/s-2004-830422
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

Patient Attitudes to Sternotomy and Thoracotomy Scars[*]

D. S. Crossland1 , S. P. Jackson1 , R. Lyall1 , J. R. L. Hamilton1 , A. Hasan1 , J. Burn2 , J. J. O'Sullivan1
  • 1Department of Paediatric Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom
  • 2Department of Clinical Genetics, International Centre for Life, Newcastle upon Tyne, United Kingdom, Work carried out at the Freeman Hospital
Further Information

Publication History

Received September 19, 2004

Publication Date:
23 March 2005 (online)

Abstract

Background: There are no data comparing patient attitudes to sternotomy and thoracotomy scars following surgery for congenital heart disease (CHD). Methods: Two hundred and one patients with a scar from CHD surgery (105 sternotomy, 36 thoracotomy, and 60 both scars) had a structured interview to explore attitudes to their scar. Results: Comparable proportions of each group reported that they did not like or hated their scar (23/105 [22 %] sternotomy, 9/36 [25 %] thoracotomy, 17/60 [28 %] both scars). Significantly more patients stated that they where embarrassed by and/or their choice of clothing was affected by a thoracotomy scar (20/36, 56 %) than those with a sternotomy scar (36/105, 34 %), p = 0.04. This was also seen when comparing sternotomy alone with both scars (36/105 [34 %] vs. 34/60 [57 %], p = 0.008). Conclusions: Adults who have undergone surgery for CHD are more likely to have a negative attitude to a thoracotomy than a sternotomy scar. Before a change in surgical approach is considered based on patient preferences, the acceptability and psychological impact of the different scars following surgery needs formal study.

1 Abstract presentation: As poster at the Association for European Paediatric Cardiology, Munich, 19 - 22 May 2004, Abstract number P98

References

  • 1 Wren C, O'Sullivan J J. Survival with congenital heart disease and need for follow-up in adult life.  Heart. 2001;  85 438-443
  • 2 Celermajer D S, Deanfield J E. Adults with congenital heart disease.  BMJ. 1991;  303 1413-1414
  • 3 van Rijen E HM, Utens E MWJ, Roos-Hesselink J W. et al . Psychosocial functioning of the adult with congenital heart disease: a 20 - 33 years follow-up.  Eur Heart J. 2003;  24 673-683
  • 4 Lane D A, Lip G YH, Millane T A. Quality of life in adults with congenital heart disease.  Heart. 2002;  88 71-75
  • 5 Van Doorn C, Yates R, Tunstill A, Elliot M. Quality of life in children following mitral valve replacement.  Heart. 2000;  84 643-647
  • 6 Ternestedt B M, Wall K, Oddsson H, Reisenfeld T, Groth I, Schollin J. Quality of life 20 and 30 years after surgery in patients operated on for tetralogy of fallot and for atrial septal defect.  Pediatr Cardiol. 2001;  22 128-132
  • 7 Kokkonen J, Paavilainen T. Social adaptation of young adults with congenital heart disease.  International J Cardiol. 1992;  36 23-29
  • 8 Bauer M, Alexi-Meskishvilli V, Nakic Z. et al . The correction of congenital heart defects with less invasive approaches.  Thorac Cardiovasc Surg. 2000;  48 67-71
  • 9 Tiete A R, Sachweh J S, Kozlik-Feldmann R, Netz H, Reichart B, Daebritz S H. Minimally invasive surgery for congenital heart defects in paediatric patients.  Thorac Cardiovasc Surg. 2002;  50 271-275
  • 10 Saunders P C, Grossi E A, Sharony R. et al . Minimally invasive technology for mitral valve surgery via left thoracotomy: Experience with forty cases.  J Thorac Cardiovasc Surg. 2004;  127 1026-1032
  • 11 Cosgrove III D M, Sabik J F, Navia J L. Minimally invasive valve operations.  Ann Thorac Surg. 1998;  65 1535-1539
  • 12 Loulmet D F, Carpentier A, Cho P W. et al . Less invasive techniques for mitral valve surgery.  J Thorac Cardiovasc Surg. 1998;  115 772-779
  • 13 Massetti M, Babatasi G, Rossi A. et al . Operation for atrial septal defect through a right anterolateral thoracotomy: current outcome.  Ann Thorac Surg. 1996;  62 1100-1103
  • 14 Cooley D A. Minimally invasive valve surgery versus the conventional approach.  Ann Thorac Surg. 1998;  66 1101-1105
  • 15 Bleiziffer S, Schreiber C, Kostolny M. et al .Cosmetic outcome of right anterolateral thoracotomy in pre-pubescent female patients. 16th Annual meeting of the EACTS. 189I. 
  • 16 Detter C, Deuse T, Boehm D H, Reichenspurner H, Reichart B. Midterm results and quality of life after minimally invasive vs. conventional aortic valve replacement.  Thorac Cardiovasc Surg. 2002;  50 337-341

1 Abstract presentation: As poster at the Association for European Paediatric Cardiology, Munich, 19 - 22 May 2004, Abstract number P98

David S. Crossland

Department of Paediatric Cardiology, Freeman Hospital

Newcastle upon Tyne, NE7 7DN

United Kingdom

Phone: + 441912137146

Fax: + 44 19 12 33 13 14

Email: davidxland@hotmail.com

    >