Comparison of clinical efficacy of minimally invasive transthoracic device closure and traditional repair with ventricular septal defect in infants
10.11958/20160038
- VernacularTitle:经胸微创封堵与传统修补术治疗婴幼儿室间隔缺损的临床效果比较
- Author:
Jian CHEN
;
Jianshi LIU
- Publication Type:Journal Article
- Keywords:
heart defects,congenital;
heart septal defects,ventricular;
surgical procedures,minimally invasive;
infant
- From:
Tianjin Medical Journal
2016;44(7):898-901,902
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the treatment effects between minimally invasive transthoracic device closure and traditional surgery on ventricular septal defect (VSD) in infants. Methods Data of 91 infants of VSD, who were less than 6 years old, were retrospectively analyzed from October 2013 to February 2015 in the department of cardiac surgery in Tianjin Chest Hospital. According to the operation mode, patients were divided into minimally invasive transthoracic device closure of VSD (closure) group (n=13) and traditional VSD repair under cardiopulmonary bypass (CPB, repair group, n=78) group. The preoperative cardiac ultrasound was used to determine the type of VSD, the distance from the margin of VSD to aortic and tricuspid valve, pulmonary artery pressure and other cardiac malformations. The intraoperative and postoperative monitoring included blood transfusion volume, valve regurgitation, mechanical ventilation time, intensive care unit (ICU) residence time, hospitalization time and hospitalization cost. The patients were followed up regularly after surgery to collect data including arrhythmia, hemolysis, valve regurgitation and residual shunt of VSD. Results There was no operative mortality in 91 patients. In closure group 1 case was converted to traditional repair surgery under CPB. There were significantly less values in ICU residence time and hospitalization time in closure group than those of the repair group[(13.2±11.7) h vs. (77.2±55.8) h, and (10.0±3.2) d vs. (15.8± 6.7) d, P<0.05]. In closure group 1 case (7.7%) underwent median sternotomy and CPB. All cases in repair group underwent median sternotomy and CPB. The infusion amount of suspended red blood cells, plasma and the time of mechanical ventilation were less in closure group than those in repair group (P < 0.05). There were no significant differences in the incidence of complications during early postoperative and the follow-up period, including arrhythmia, VSD residual shunt, valve regurgitation, hemolysis, and the cost of hospitalization between two groups (P>0.05). Conclusion In the comparison of the recent or short-term clinical curative effect of VSD treatment in infants, the minimally invasive transthoracic VSD device closure is better than the traditional VSD repair treatment. Long term effects need to be further observed and followed up.
