Early results of modified double-orifice valve plasty via total thoracoscopy for partial atrioventricular septal defect

Hailong QIU; Tianyu CHEN; Zewen CHEN; Zhanhao SU; Miao TIAN; Zhao CHEN; Hongkun QING; Shusheng WEN; Jianzheng CEN; Jimei CHEN; Xiaohua LI

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Early results of modified double-orifice valve plasty via total thoracoscopy for partial atrioventricular septal defect

VernacularTitle:全胸腔镜下改良双孔法矫治部分型房室间隔缺损的早期结果
Author: Hailong QIU ¹ ; Tianyu CHEN ¹ ; Zewen CHEN ¹ ; Zhanhao SU ¹ ; Miao TIAN ¹ ; Zhao CHEN ¹ ; Hongkun QING ¹ ; Shusheng WEN ¹ ; Jianzheng CEN ¹ ; Jimei CHEN ¹ ; Xiaohua LI ¹
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1. 广东省心血管病研究所　广东省华南结构性心脏病重点实验室　心血管人工智能与三维技术实验室南方医科大学附属广东省人民医院（广东省医学科学院）心外科，广州　510080
Publication Type:Journal Article
Keywords: Partial atrioventricular septal defect; Modified double-orifice valve plasty; Total thoracoscopy
From: Chinese Journal of Thoracic and Cardiovascular Surgery 2025;41(6):328-333
CountryChina
Language:Chinese
Abstract: Objective:To evaluate the safety, efficacy, advantages and disadvantages of the modified double-orifice valve plasty via total thoracoscopy for partial atrioventricular septal defect(PAVSD) through a retrospective analysis of early postoperative results.Methods:Patients diagnosed with PAVSD who underwent the standardized modified double-orifice valve plasty via total thoracoscopy between September 2023 and August 2024 were retrospectively enrolled. Baseline characteristics, surgical parameters, and follow-up outcomes were systematically analyzed.Results:A total of 14 patients(6 males, 8 females) were included, with a mean age of(32.9±15.5) years old and body weight of(55.1±11.6) kg. All procedures were successfully completed. The mean operative time, cardiopulmonary bypass time, and aortic cross-clamp time were(266.6±67.2) min, (160.7±34.2) min, and(97.0±31.1) min, respectively. Postoperative ICU stay, hospital stay, and total hospitalization duration were(1.7±1.1) days, (6.4±4.2) days, and(12.6±4.5) days, respectively. The mean follow-up duration was(7.9±3.6) months. Preoperatively, left atrioventricular valve regurgitation(LAVVR) was graded as mild, moderate, or severe in 5, 4, and 5 patients. Postoperatively, 13 patients exhibited mild or less LAVVR, with 1 case of moderate regurgitation. By 3 months, all patients demonstrated LAVVR of mild or lower severity, which remained stable through follow-up. Peak LAVV gradients were(4.6±2.7) mmHg(1 mmHg=0.133 kPa)(range: 1.8-10.2 mmHg) postoperatively, improving to(3.6±0.6) mmHg(3.2-4.0) mmHg at 1 year. Right atrioventricular valve regurgitation improved from preoperative moderate-severe(50.0%) to LAVVR of mild or lower severity in all patients by 3 months. No mortality, residual shunts, or high-grade atrioventricular block occurred through follow-up. By 1 month, NYHA functional class improved to Ⅰ in all patients, which remained stable through follow-up.Conclusion:Standardized modified double-orifice valve plasty via total thoracoscopy for PAVSD demonstrates safety, minimal invasiveness, and rapid recovery, with favorable early outcomes.