Minimally Invasive Perventricular Ventricular Septal Defect Closure_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YANGShi-hai , WENLin-lin , SONGHai-long , TAOShu-guang , ZHUXiao-li ,  WANGJian-ming

Department of Cardiac Surgery, Children's Hospital of Hebei Province, Shijiazhuang 050031, P. R. China;

Corresponding?author：

WANGJian-ming, Email: wang_li_w@yahoo.com

Keywords：

Ventricular septal defect; Minimally invasive incision; Transesophageal echocardiography; Transthoracic occlusion

DOI：

10.7507/1007-4848.20150252

Video：

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Objective To summarize the experiences of minimally invasive occlusion of ventricular septal defect (VSD) via small chest incision. Methods We retrospectively analyzed the clinical data of 131 infants with VSD in Hebei children's Hospital between March 2013 and September 2014, including 83 patients with perimembranous VSD, 24 patients with membranous aneurysm and 24 patients with intracristal VSD. There were 63 males and 68 females with a mean age of 35.28±29.22 months and a mean body weight of 14.56±7.47 kg. Before surgery, a multiple-section transthoracic echocardiography (TTE) was employed to evaluate various parameters of the VSD. Under general anesthesia, a small incision was made to expose the right ventricle. Under TEE guidance, proper device was delivered and deployed to close the defect. Patients also received postoperative following-up by transesophageal echocardiogram (TEE) at regular intervals. Results One hundred twenty-nine patients were successfully performed operation. Two patients were converted to perform traditional surgical closure with cardiopulmonary bypass (cPB). concentric devices were used in 52 patients and eccentric devices were used in 77 patients. During the following-up (1-12 months) period, complications occurred in three patients. Massive pericardial effusion appeared and disappeared after pericardicentesis in one patient. The occlusion device was dislocated in the next day after operation and took out by cPB operation in one patient. There was an asymptomatic residual shunt at 1 mm in one patient. Conclusion The minimally invasive occlusion of VSD via small chest incision is a safe and effective treatment. It should be encouraged to use in the clinical practice.

Citation： YANGShi-hai, WENLin-lin, SONGHai-long, TAOShu-guang, ZHUXiao-li, WANGJian-ming. Minimally Invasive Perventricular Ventricular Septal Defect Closure. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(11): 1011-1015. doi: 10.7507/1007-4848.20150252 Copy

1.	張亞飛,王克學,王巖青,等.經胸微創室間隔缺損封堵術50例療效分析.心肺血管病雜志,2014,33(3):395-401.
2.	邢泉生,武欽.經胸微創非體外循環下封堵室間隔缺損的研究進展.中華胸心血管外科雜志,2011,27(5):257-258.
3.	Moodie DS.Technology insight:transcatheter closure of ventricular septal defects.Nat clin Pract cardiovasc Med,2005,2(11):592-596.
4.	Xunmin c,Shisen J,Jianbin G,et al.comparison of results and complications of surgical and Amplatzer device closure of perimembranous ventricular septal defects.Int J cardiol,2007,120(1):28-31.
5.	中國醫師協會心血管內科分會先心病工作委員會.常見先天性心臟病介入治療中國專家共識.介入放射學雜志,2011,20(2):87-92.
6.	Majunke N,Sievert H.Atrial and ventricular shunt closure.J Invasive cardiol,2008,20(3):93-96.
7.	Butera G,carminati M,chessa M,et al.Transcatheter closure of perimembranous ventricular septal defects:early and long-term results.J Am coll cardiol,2007,50(12):1189-1195.
8.	Amin Z,Berry JM,Foker JE,et al.Intraoperative closure of muscular ventricular septal defects in a canine model and application of the technique in a baby.J Thorac cardiovasc Surg,1998,115(6):1374-1376.
9.	Bacha EA,cao QL,Starr JP,et al.Perventricular device closure of muscular ventricular septal defects on the beating heart:technique and results.J Thorac cardiovasc Surg,2003,126(6):1718-1723.
10.	Amin Z,Woo R,Danford DA,et al.Robotically assisted perventricular closure of perimembranous ventricular septal defects:preliminary results in Yucatan pigs.J Thorac cardiovasc Surg,2006,131(2):427-432.
11.	邢泉生,莊忠云,泮思林,等.應用新型輸送系統經胸微創封堵膜周部室間隔缺損.中華實驗外科雜志,2007,24(9):1135-1136.
12.	Li F,chen M,Qiu Z,et al.A new minimally invasive technique to occlude ventricular septal defect using an occluder device.Ann Thorac Surg,2008,85(3):1067-1071.
13.	Xing Q,Wu Q,Pan S,et al.Transthoracic device closure of ventricular septal defects without cardiopulmonary bypass:experience in infants weighting less than 8 kg.Eur J cardiothorac Surg,2011,40(3):591-597.
14.	郭俊曉,劉志平,朱憲明,等.經胸微創室間隔缺損封堵術38例臨床分析.中國胸心血管外科臨床雜志,2013,20(6):728-730.
15.	李小波,萬亞紅,鄔云,等.低齡低體重患兒經胸小切口封堵膜周部室間隔缺損的策略及早期療效.中國微創外科雜志,2012,12(11):964-968.
16.	中國醫師協會心血管外科醫師分會.經胸微創室間隔缺損封堵術中國專家共識.中華胸心血管外科雜志,2011,27(9):516-518.
17.	Seeburger J,Borger MA,Doll N,et al.comparison of outcomes of minimally invasive mitral valve surgery for posterior,anterior and bileaflet prolapse.Eur J cardiothorac Surg,2009,36(3):532-538.
18.	賃可,干昌平,唐紅,等.經心室穿刺封堵嬰幼兒非肌部室間隔缺損39例.中華胸心血管外科雜志,2008,24(6):367-369.
19.	Li F,chen M,Qiu Z,et al.A new minimally invasive technique to occlude ventricular septal defect using an occluder device.Ann Thorac Surg,2008,85(3):1067-1071.
20.	Predescu D,chaturvedi RR,Friedberg MK,et al,complete heart block associated with device closure of perimembranous ventricular septal defects.J Thorac cardiovasc Surg,2008,136(5):1223-1228.

1. 張亞飛,王克學,王巖青,等.經胸微創室間隔缺損封堵術50例療效分析.心肺血管病雜志,2014,33(3):395-401.
2. 邢泉生,武欽.經胸微創非體外循環下封堵室間隔缺損的研究進展.中華胸心血管外科雜志,2011,27(5):257-258.
3. Moodie DS.Technology insight:transcatheter closure of ventricular septal defects.Nat clin Pract cardiovasc Med,2005,2(11):592-596.
4. Xunmin c,Shisen J,Jianbin G,et al.comparison of results and complications of surgical and Amplatzer device closure of perimembranous ventricular septal defects.Int J cardiol,2007,120(1):28-31.
5. 中國醫師協會心血管內科分會先心病工作委員會.常見先天性心臟病介入治療中國專家共識.介入放射學雜志,2011,20(2):87-92.
6. Majunke N,Sievert H.Atrial and ventricular shunt closure.J Invasive cardiol,2008,20(3):93-96.
7. Butera G,carminati M,chessa M,et al.Transcatheter closure of perimembranous ventricular septal defects:early and long-term results.J Am coll cardiol,2007,50(12):1189-1195.
8. Amin Z,Berry JM,Foker JE,et al.Intraoperative closure of muscular ventricular septal defects in a canine model and application of the technique in a baby.J Thorac cardiovasc Surg,1998,115(6):1374-1376.
9. Bacha EA,cao QL,Starr JP,et al.Perventricular device closure of muscular ventricular septal defects on the beating heart:technique and results.J Thorac cardiovasc Surg,2003,126(6):1718-1723.
10. Amin Z,Woo R,Danford DA,et al.Robotically assisted perventricular closure of perimembranous ventricular septal defects:preliminary results in Yucatan pigs.J Thorac cardiovasc Surg,2006,131(2):427-432.
11. 邢泉生,莊忠云,泮思林,等.應用新型輸送系統經胸微創封堵膜周部室間隔缺損.中華實驗外科雜志,2007,24(9):1135-1136.
12. Li F,chen M,Qiu Z,et al.A new minimally invasive technique to occlude ventricular septal defect using an occluder device.Ann Thorac Surg,2008,85(3):1067-1071.
13. Xing Q,Wu Q,Pan S,et al.Transthoracic device closure of ventricular septal defects without cardiopulmonary bypass:experience in infants weighting less than 8 kg.Eur J cardiothorac Surg,2011,40(3):591-597.
14. 郭俊曉,劉志平,朱憲明,等.經胸微創室間隔缺損封堵術38例臨床分析.中國胸心血管外科臨床雜志,2013,20(6):728-730.
15. 李小波,萬亞紅,鄔云,等.低齡低體重患兒經胸小切口封堵膜周部室間隔缺損的策略及早期療效.中國微創外科雜志,2012,12(11):964-968.
16. 中國醫師協會心血管外科醫師分會.經胸微創室間隔缺損封堵術中國專家共識.中華胸心血管外科雜志,2011,27(9):516-518.
17. Seeburger J,Borger MA,Doll N,et al.comparison of outcomes of minimally invasive mitral valve surgery for posterior,anterior and bileaflet prolapse.Eur J cardiothorac Surg,2009,36(3):532-538.
18. 賃可,干昌平,唐紅,等.經心室穿刺封堵嬰幼兒非肌部室間隔缺損39例.中華胸心血管外科雜志,2008,24(6):367-369.
19. Li F,chen M,Qiu Z,et al.A new minimally invasive technique to occlude ventricular septal defect using an occluder device.Ann Thorac Surg,2008,85(3):1067-1071.
20. Predescu D,chaturvedi RR,Friedberg MK,et al,complete heart block associated with device closure of perimembranous ventricular septal defects.J Thorac cardiovasc Surg,2008,136(5):1223-1228.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Minimally Invasive Perventricular Ventricular Septal Defect Closure

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