Perimembranous ventricular septal defect performed super minimally invasive trans intercostal device closure under the guidance of transesophageal echocardiography in children
10.3760/cma.j.issn.1001-4497.2017.07.005
- VernacularTitle:食管超声引导下经肋间超微切口封堵小儿膜周部室间隔缺损
- Author:
Jin YU
;
Xucong SHI
;
Zewei ZHANG
;
Jingjing YE
;
Lianglong MA
;
Jianchuan QI
;
Guoping JIANG
- Keywords:
Echocardiography,transesophageal;
Perimembranous ventricular septal defect;
Cardiac surgical operation,minimally invasive;
Closure;
Child
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2017;33(7):400-403
- CountryChina
- Language:Chinese
-
Abstract:
Objective This study was aimed to discuss the safety, feasibility and availability of perimembranous ventricular septal defects(PmVSD) closure via super minimal intercostal incision under transesophageal echocardiography(TEE) guidance in children.Methods There were 81 cases of PmVSD via super minimally invasive transintercostal device closure operation(length of incision ≤ 1cm) from August 2014 to August 2016.TEE was used to guide and monitor the entire procedure.Assessed the effectiveness of device closure by postoperative regular follow-up.Results 80 patients were successfully operated by super minimally invasive transintercostal device closure in all 81 cases.Operation success rate reached 98.77%.The average diameter of ventricular septal defects was(3.72±0.96)mm.The average diameter of amplatzer occluder was(4.88±0.95)mm.Postoperative follow-up time was from 6 months to 24 months.One of 16 cases that with aneurysm of membranous septum had more than two shunts, remained a mild residual shunt beside of the amplatzer occluder but self cured during follow-up.Mild pericardial effusion was found in one patients after the operation and disappeared during follow-up.There were no cases of perioperative death, device deformation or displacement, residual shunt, complete atrioventricular block and valve involvement in the patients whom were successfully operated.One patient transferred to ventricular septal defect repair operation under direct visualization with a cardiopulmonary bypass, because ventricular fibrillation happened when guide wire passed the ventricular septal.Conclusion Super minimally invasive transintercostal device closure of PmVSD in children guided by TEE was safety and availability, that could avoid x-ray radiation and sternotomy, and operate simply, with small incision and low complication.
