Influencing factors and outcomes of atrial septal defect or ventricular septal defect occlusion guided by echocardiography_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 LIU Jian , TANG Xiancheng , HUANG Jixiu , LIN Xiaobin

Department of Cardiac Surgery, People's Hospital of Jianyang City, Jianyang, 641499, Sichuan, P.R.China;

Corresponding?author：

LIU Jian, Email: liujiun688@sina.com

Keywords：

Atrial septal defect; ventricular septal defect; echocardiography; minimally invasive; occluder

DOI：

10.7507/1007-4848.201801052

Video：

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Objective To analyze the influencing factors and outcomes of atrial septal defect (ASD) and ventricular septal defect (VSD) occlusion guided by echocardiography. Methods We retrospectively analyzed the clinical data of 188 patients receiving transthoracic and percutaneous transcatheter closure of ASD and VSD from July 2009 to July 2017 in our department, including 74 males and 114 females, aged 13.48±13.53 years ranging from 1 to 65 years. Results Fifty-three ASD patients accepted transthoracic closure surgery, of whom 4 patients were difficult to close and 6 patients failed to close; 24 patients underwent percutaneous transcatheter ASD occlusion surgery, of whom 3 were difficult to close and 1 failed in occlusion; 108 VSD patients implemented transthoracic closure surgery, of whom 10 patients were difficult to close and 5 patients failed in closure; 9 VSD patients underwent percutaneous transcatheter closure, of whom 5 failed and then was converted to transthoracic closure. Our study showed that too large or too small aperture was the independent risk factor. Two kinds of closure surgery had their own advantages and disadvantages. The special type of VSD was the influencing factor of transthoracic closure. Conclusion When the ASD diameter≥25 mm, transthoracic closure is the best choice to avoid the use of large occluder. When the ASD diameter<25 mm, percutaneous closure surgery is the best choice. When the ASD diameter≥35 mm, it is best to give up the closure operation. Technical improvements can significantly raise the closure success rate of the subarterial VSD. For the entry diameter>10 mm and membranous aneurysm with multi-break, occlusion surgery should be avoided in VSD.

Citation： LIU Jian, TANG Xiancheng, HUANG Jixiu, LIN Xiaobin. Influencing factors and outcomes of atrial septal defect or ventricular septal defect occlusion guided by echocardiography. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(12): 1060-1063. doi: 10.7507/1007-4848.201801052 Copy

1.	Guo QK, Lu ZQ, Cheng SF, et al. Off-pump occlusion of transthoracic minimally invasive surgery (OPOTTMIS) on simple congenital heart diseases (ASD, VSD and PDA) attached consecutive 210 cases report: a single institute experience. J Cardiothorac Surg, 2011, 6(1): 48-57.
2.	Michel-Behnke I, Ewert P, Koch A, et al. Device closure of ventricular septal defects by hybrid procedures: a multicenter retrospective study. Catheter Cardiovasc Interv, 2011, 77(2): 242-251.
3.	國家衛生和計劃生育委員會經外科途徑心血管疾病介入診療專家工作組. 常見心血管疾病經外科途徑進行介入診療的專家共識. 中國循環雜志, 2017, 32(2): 105-119.
4.	劉健, 黃擊修, 林小彬, 等. 室間隔缺損經胸小切口封堵的應用價值. 心血管外科雜志(電子版), 2014, 3(1): 26-28.
5.	李偉, 顧偉禮, 勵峰, 等. 微創經胸小切口室間隔缺損封堵術的臨床應用. 中國胸心血管外科臨床雜志, 2016, 23(2): 191-193.
6.	潘湘斌, 逄坤靜, 歐陽文斌, 等. 單純超聲心動圖引導下經皮室間隔缺損封堵術的應用研究. 中國循環雜志, 2015, 30(8): 774-776.
7.	劉志平, 趙龍, 李淑珍, 等. 微創經胸小切口室間隔缺損封堵術臨床分析. 中國心血管病研究, 2017, 15(1): 26-29.
8.	邢泉生. 如何理性看待先天性心臟病經胸微創封堵技術的迅速發展. 國際心血管病雜志, 2016, 43(3): 129-132.
9.	潘湘斌, 歐陽文斌, 王首正, 等. 單純超聲引導下經頸靜脈室間隔缺損封堵術的探索研究. 中國循環雜志, 2015, 30(12): 1204-1207.
10.	吳文海, 王清木, 顏如玉, 等. 超聲心動圖引導經胸小切口室間隔缺損封堵術臨床分析. 中外醫療, 2017, 36(12): 1-3, 15.
11.	王廣闊, 蔡麗霞, 張志剛, 等. 食管超聲引導經胸室間隔缺損封堵術的臨床體會. 中國心血管病研究, 2016, 14(12): 1127-1129.
12.	何小梅, 郭學佳, 張寧, 等. 超聲監護下國產器材封堵房間隔缺損的心導管法與經胸小切口法對比分析. 中南大學學報(醫學版), 2017, 42(6): 629-634.
13.	楊秋藍, 張燕搏, 潘湘斌, 等. 經胸微創封堵術治療先天性心臟病臨床分析. 中華實用診斷與治療雜志, 2016, 30(4): 363-365.
14.	Lin K, Zhu D, Tao K, et al. Hybrid perventricular device closure of doubly committed subarterial ventricular septal defects: mid-term results. Catheter Cardiovasc Interv, 2013, 82(3): E225-E232.
15.	Pan S, Xing Q, Cao Q, et al. Perventricular device closure of doubly committed subarterial ventral septal defect through left anterior minithoracotomy on beating hearts. Ann Thorac Surg, 2012, 94(6): 2070-2075.
16.	馬倫超, 陸國梁, 楊超, 等. 左胸骨旁小切口封堵分流方向偏向流出道的室間隔缺損 15 例. 中國胸心血管外科臨床雜志, 2016, 23(3): 304-306.

1. Guo QK, Lu ZQ, Cheng SF, et al. Off-pump occlusion of transthoracic minimally invasive surgery (OPOTTMIS) on simple congenital heart diseases (ASD, VSD and PDA) attached consecutive 210 cases report: a single institute experience. J Cardiothorac Surg, 2011, 6(1): 48-57.
2. Michel-Behnke I, Ewert P, Koch A, et al. Device closure of ventricular septal defects by hybrid procedures: a multicenter retrospective study. Catheter Cardiovasc Interv, 2011, 77(2): 242-251.
3. 國家衛生和計劃生育委員會經外科途徑心血管疾病介入診療專家工作組. 常見心血管疾病經外科途徑進行介入診療的專家共識. 中國循環雜志, 2017, 32(2): 105-119.
4. 劉健, 黃擊修, 林小彬, 等. 室間隔缺損經胸小切口封堵的應用價值. 心血管外科雜志(電子版), 2014, 3(1): 26-28.
5. 李偉, 顧偉禮, 勵峰, 等. 微創經胸小切口室間隔缺損封堵術的臨床應用. 中國胸心血管外科臨床雜志, 2016, 23(2): 191-193.
6. 潘湘斌, 逄坤靜, 歐陽文斌, 等. 單純超聲心動圖引導下經皮室間隔缺損封堵術的應用研究. 中國循環雜志, 2015, 30(8): 774-776.
7. 劉志平, 趙龍, 李淑珍, 等. 微創經胸小切口室間隔缺損封堵術臨床分析. 中國心血管病研究, 2017, 15(1): 26-29.
8. 邢泉生. 如何理性看待先天性心臟病經胸微創封堵技術的迅速發展. 國際心血管病雜志, 2016, 43(3): 129-132.
9. 潘湘斌, 歐陽文斌, 王首正, 等. 單純超聲引導下經頸靜脈室間隔缺損封堵術的探索研究. 中國循環雜志, 2015, 30(12): 1204-1207.
10. 吳文海, 王清木, 顏如玉, 等. 超聲心動圖引導經胸小切口室間隔缺損封堵術臨床分析. 中外醫療, 2017, 36(12): 1-3, 15.
11. 王廣闊, 蔡麗霞, 張志剛, 等. 食管超聲引導經胸室間隔缺損封堵術的臨床體會. 中國心血管病研究, 2016, 14(12): 1127-1129.
12. 何小梅, 郭學佳, 張寧, 等. 超聲監護下國產器材封堵房間隔缺損的心導管法與經胸小切口法對比分析. 中南大學學報(醫學版), 2017, 42(6): 629-634.
13. 楊秋藍, 張燕搏, 潘湘斌, 等. 經胸微創封堵術治療先天性心臟病臨床分析. 中華實用診斷與治療雜志, 2016, 30(4): 363-365.
14. Lin K, Zhu D, Tao K, et al. Hybrid perventricular device closure of doubly committed subarterial ventricular septal defects: mid-term results. Catheter Cardiovasc Interv, 2013, 82(3): E225-E232.
15. Pan S, Xing Q, Cao Q, et al. Perventricular device closure of doubly committed subarterial ventral septal defect through left anterior minithoracotomy on beating hearts. Ann Thorac Surg, 2012, 94(6): 2070-2075.
16. 馬倫超, 陸國梁, 楊超, 等. 左胸骨旁小切口封堵分流方向偏向流出道的室間隔缺損 15 例. 中國胸心血管外科臨床雜志, 2016, 23(3): 304-306.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Influencing factors and outcomes of atrial septal defect or ventricular septal defect occlusion guided by echocardiography

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