Surgical Breakthrough Allows Discreet Scar for Pediatric Heart Patients
SACRAMENTO, Calif. – Sutter Medical Center, Sacramento pediatric cardiothoracic surgeon Dr. Naruhito Watanabe is believed to be the first surgeon in the United States to repair an atrial septal defect (ASD) via a right mini-thoracotomy, with an incision just below the armpit. This minimally invasive approach reduces the healing time for the young patients and allows them to grow up without having embarrassing chest scars.
An ASD is a hole in the wall between the two upper chambers of the heart, called the atria. Some of these holes may spontaneously close as the infant grows; however, it is one of the more common congenital heart defects requiring surgical repair, with about 40,000 children are born each year with congenital heart defects in the United States alone.
One of Dr. Watanabe’s patients, 3-year-old Taneigha Avila of Sacramento, recently underwent this minimally invasive procedure and now has a repaired ASD with an incision that is barely noticeable. The patient’s recovery was phenomenal and the family has been very pleased with the results.
“Just a couple of weeks after the surgery, you wouldn’t even know she had heart surgery,” Taneigha’s mother, Lana, said. “She’s completely recovered and the scar is barely visible. I am definitely an advocate for this surgery.”
The usual open-heart surgery creates an incision through the sternum – in the middle of the chest from just below the neck to just above the bellybutton. With this open-chest approach, in addition to creating a long chest scar, there are six weeks of post-operative restrictions to allow for the sternum to properly heal. Dr. Watanabe pioneered this new surgical technique because many children with congenital heart defects grow up to be self-conscious about the long scars created with traditional open-heart surgeries and because the six weeks of post-operative sternal precautions can be difficult for children.
Dr. Watanabe is a clinical assistant professor of pediatric cardiothoracic surgery at Stanford’s Lucile Packard Children’s Hospital and performs pediatric heart surgeries at Sutter Medical Center, Sacramento. Dr. Watanabe researched the most discreet area on a child that would be the least visible when wearing a swimsuit or V-neck T-shirts, yet would give him excellent access to the location of the defect in the heart. The area on the right side under the armpit will usually be covered up by a bra strap or bathing suit top, and would also be very discreet for boys.
“With the right mini-thoracotomy, there’s no visible incision from the front,” said Dr. Watanabe. “As the girl grows into womanhood, the scar will be covered by a bra or bikini strap. So when she will go swimming, work out or play sports, no one will know she has had surgery.”
Taneigha’s pediatric cardiologist, Dr. Hessam Fallah, is also excited about this surgical technique since “having a long scar in the middle of the chest is a concern for some of the patients, especially young ones. Some of the incisions become well-healed, but sometimes the scar is very thick. It is a nice alternative to the typical procedure and is safe. It’s a much smaller incision, and its location is also where it can be hidden quite easily, rather than middle of the chest.”
Taneigha was the second child to have the surgery using this new, minimally invasive approach, and Dr. Watanabe hopes to perform other ASD repairs with this mini-thoracotomy. He also hoped to pioneer other congenital heart defect repairs using this new technique.