目的：  探究通过右腋下垂直切口同时行先天性心内畸形矫治和动脉导管未闭(PDA)结扎术的有效性和安全性。

方法： 回顾性分析我院从2014年8月至2019年8月通过右腋下垂直切口同时行先天性心脏病心内畸形矫治和PDA结扎术的34例患者的临床资料，年龄0.5~6.1岁，男性25例，女性9例。

结果： 手术切口长度为3.0 (3.0,3.5)cm，手术时间为110 (90,121)min，体外循环时间为45.5 (38.8, 63.5)min，主动脉阻断时间为22.5 (14.8,34.8)min，出血量为20.0 (13.8,20.0)ml，住ICU时间为17.0 (5.5,22.3)h，术后机械通气时间为4.0 (2.0,6.0)h，住院总费用为46391.4 (38905.2,51423.9)RMB。围手术期和随访期间均无死亡及二次手术。中位随访时间为646天，失访2例，随访率94.1%，随访期间有1例患者存在小的残余分流，1例患者由于疤痕体质手术切口局部轻微不适感，未发现新发的脊柱侧弯、漏斗胸或鸡胸等胸廓发育异常。女性患者在随访期间无双侧乳腺发育不对称。所有患者的父母或监护人均对右腋下垂直美容切口满意。

结论： 通过右腋下垂直切口同时进行先天性心内畸形矫治及PDA结扎术是一种安全有效的方法，具有良好的临床和美容学结果。

Objective: To investigate effectiveness and safety of right vertical infra-axillary thoracotomy (RVIAT) in surgical repair for intracardiac anomalies combined with patent ductus arteriosus (PDA). 

Methods: We retrospectively analyzed the clinical data of 34 patients who underwent intracardiac correction of congenital heart defects and PDA ligation simultaneously via RVIAT in our hospital from August 2014 to August 2019. There were 25 males and 9 females included in the study, with an age range of 0.5~6.1 years. 

Results: The length of incision was 3.0 (3.0,3.5) cm. The operation time lasted 110 (90,121) min. The cardiopulmonary bypass time was 45.5 (38.8, 63.5) min and the aortic cross-clamp time was 22.5 (14.8,34.8) min. The bleeding volume was 20.0 (13.8,20.0) ml. ICU stay time was 17.0 (5.5,22.3) h, post-operative mechanical ventilation time was 4.0 (2.0,6.0) h, total in-hospital cost was 46391.4 (38905.2,51423.9) RMB. There was no mortality or reoperation during perioperative and follow-up period. Within the median follow-up of 646 days, 1 patient had minimal residual ventricular septal defect shunt while no new-onset scoliosis, funnel chest or pectus carinatum was detected. 1 patient had minor discomfort at local surgical incision area. No bilateral mammary developmental asymmetry was observed in female patients during the follow-up period. All the patients’ parents or guardians were satisfied with the right vertical infra-axillary aesthetic skin incision. 

Conclusions: The minimally invasive repair for intracardiac heart defects combined with PDA via right vertical infra-axillary thoracotomy is a safe and effective method with minimal invasiveness and excellent cosmesis.