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
1
;
Zewei ZHANG
2
;
Jianhua LI
2
;
Jingjing QIAN
1
;
Xiuzhen YANG
1
;
Lianglong MA
2
Author Information
1. Department of Echocardiography, Children′s Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China
2. Department of Cardiac Surgery, Children′s Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China
- Publication Type:Clinical Trail
- 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 (TEE) 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. The whole operation, including preoperative evaluation, intraoperative localization and guidance and postoperation evaluation were performed under the guidance of TEE.
Results:Forty-six children with high VSD underwent successfully device closure in all 48 cases and the operation success rate was 95.8%. The 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. The average operation duration was 18-98 (49.80±16.71)min. There were 2 cases of peri-membranous high VSD and 44 cases of outlet-typle VSD, of which 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. The 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, TEE 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.
