Application of transesophageal echocardiography in high ventricular septal defect closure via the small intercostal incision with eccentric occluder in children
10.3760/cma.j.issn.1004‐4477.2019.10.004
- VernacularTitle:经食管超声在经左侧肋间小切口封堵小儿高位室间隔缺损中的应用价值
- Author:
Jin YU
1
;
Jingjing YE
;
Zewei ZHANG
;
Jianhua LI
;
Jingjing QIAN
;
Xiuzhen YANG
;
Lianglong MA
Author Information
1. 浙江大学医学院附属儿童医院超声科
- Keywords:
Echocardiography,transesophageal;
Ventricular septal defect;
Minimal surgical procedures;
Children
- From:
Chinese Journal of Ultrasonography
2019;28(10):849-853
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the value of transesophageal echocardiography ( T EE ) in high ventricular septal defect ( VSD) occlusion via a left parasternal ultra‐minimal intercostal incision ( ≤1 cm ) with eccentric occluder in children . Methods Forty‐eight children with high VSD underwent device occlusion via ultraminimal intercostal incision with eccentric occluder . T he w hole operation , including preoperative evaluation ,intraoperative localization and guidance and postoperation evaluation were performed under the guidance of T EE . Results Forty‐six children with high VSD underwent successfully device closure in all 48 cases and the operation success rate was 95 .8% . T he average size of high VSD was 2 .2－6 .0 ( 3 .70 ± 0 .90) mm and the average size of eccentric occluder was 4－8 ( 5 .48 ± 1 .12) mm . T he average operation duration was 18－98 ( 49 .80 ± 16 .71) min . T here were 2 cases of peri‐membranous high VSD and 44 cases of outlet‐typle VSD ,of w hich 10 cases of mild aortic valve prolapses ( AVOP) ,including 5 cases of aortic valve regurgitation ( AR ) . In addition ,there was 1 case of replacement of device ,1 case of having septum below the margin of the defect and 1 case of using a dilator for a small defect . T he 46 cases were followed up for 6 to 42 months ,and the pericardial effusion occured in 3 cases and disappeared during follow‐up . No other abnormal conditions were found . Conclusions During the surgery of high VSD device occlusion via ultraminimal intercostal incision with eccentric occluder ,T EE has an important value in defect assessment ,intraoperative localization and guidance ,and immediate evaluation of efficacy ,and can effectively guide the device occlusion of high VSD .
