Minimally invasive experiences and medium-long-term results of perventricular device closure of ventricular septal defects in 783 children: A retrospective analysis in a single center
- VernacularTitle:小儿经胸微创封堵室间隔缺损783 例中远期结果的单中心回顾性分析
- Author:
Xuning LU
1
,
2
;
Yuhang LIU
1
,
2
;
Quanwei ZHU
1
,
2
;
Ning WANG
1
,
2
;
Ping WEN
1
,
2
Author Information
1. Department of Heart Center, Children&rsquo
2. s Hospital of Dalian Medical University, Dalian, 116012, Liaoning, P. R. China
- Publication Type:Journal Article
- Keywords:
Congenital heart disease;
ventricular septal defect;
minimally invasive surgery;
cardiac surgical procedures
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2022;29(09):1161-1165
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the minimally invasive experiences and medium-long-term results of perventricular device closure of ventricular septal defects (VSD) under transesophageal echocardiography (TEE) guidance. Methods We retrospectively analyzed the clinical data and medium-long-term follow-up results of 783 patients who undertook perventricular device closure under TEE guidance in Dalian Children’s Hospital from July 2011 to January 2020, in which perimembrane VSD were found in 598 patients, VSD with aortic valve prolapse in 135 patients and muscular VSD in 2 patients. There were 463 males and 320 females at age of 5 months to 13 years with average age of 3.3±1.2 years, and body weight of 5.9-51.0 (15.9±8.3) kg. The left ventricular defect diameter of the VSD ranged from 5.0 to 11.0 mm, with an average of 6.3±1.2 mm. The right ventricular defect diameter of the VSD ranged from 2.3 to 8.0 mm, with an average of 4.3±0.9 mm. Results The procedures were completed successfully in 753 patients. The device of 1 patient (0.1%) fell off and embedded in the right pulmonary artery after the operation, and the occluder was taken out and the VSD was closed with cardiopulmonary bypass (CPB) in the secondary operation. One patient (0.1%) appeared Ⅲ degree atrioventricular block in 2 years after operation. The device was taken out and VSD was closed with CPB in the secondary operation, and the patient gradually reached to sinus rhythm in post-operation. Eight patients (1.1%) presented delayed pericardial effusion in 1 week after operation, and were cured by pericardiocentesis with ultrasound-guided. Symmetric occluders were used in 580 patients, eccentric occleders were used in 171 patients and muscular occluders were used in 2 patients. The follow-up time was 9 months to 9 years. The rate of loss to follow-up was 96.7% (704/728). No residual shunt, occlude-loss or arrhythmia was found during follow-up. Conclusion The minimally invasive penventricular device closure of VSD guided by TEE is safe and availabe. Medium-long-term follow-up results are satisfactory, it is worthy of clinical promotion, and longer term follow-up is still needed.
