ObjectiveTo evaluate the feasibility and safety of blocking congenital ventricular septal defect or congenital atrial septal defect through the small vertical incision of right subaxillary.
MethodsWe retrospectively analyzed the clinical data of 38 patients underwent the surgery of blocking congenital ventricular septal defect or congenital atrial septal defect in our hospital from January to August 2015. There were 22 males and 16 females with a mean age of 10.3±5.2 months, weight of 8.2±3.5 kg.
ResultsThere were 34 patients (89.5%) successfully blocked through the small vertical cut of right subaxillary. The average blood loss of those 34 patients was 19.5±13.4 ml and the mean time of surgery was 58.4±28.5 minutes. Four patients (10.5%) with ventricular septal defect failed to block because of aortic valve prolapse. Those patients underwent direct repair of ventricular septal defect under extracorporeal circulation while general anesthesia. There was no serious adverse event during the surgery. The extubation time was 3.9±1.6 hours, the ICU monitoring time was 1.8±0.8 days and the hospital stay time was 3.2±0.5 days. All patients discharged uneventfully.
ConclusionBlocking congenital ventricular septal defect or congenital atrial septal defect through the cut of right subaxillary is a feasible, effective, safe, and minimally invasive method. The effect of early follow-up is well.
ObjectiveTo analyze the clinical efficacy of transthoracic occlusion via a right subaxillary incision and conventional surgery in the treatment of ventricular septal defect (VSD).MethodsThe clinical data of patients with congenital VSD undergoing right subaxillary incision surgery in our hospital from January 2017 to January 2020 were retrospectively analyzed. According to the surgical methods, the patients were divided into two groups: a conventional surgery group (conventional group) and a transthoracic occlusion group (occlusion group). There were 221 patients in the conventional group, including 97 males and 124 females, with an average age of 2.6±2.2 years and an average weight of 13.4±6.2 kg; there were 185 patients in the occlusion group, including 90 males and 95 females, with an average age of 3.2±2.6 years and an average weight of 14.7±6.6 kg. The clinical effectiveness was compared.ResultsThe success rate of surgery was 100% in both groups. The intraoperative blood loss was less in the occlusion group (P<0.05). The incision length, operation time, postoperative mechanical ventilation time, retention time in the intensive care unit, the time to resume normal diet and normal activities after operation were all shorter than those in the conventional group (P all <0.05). The total cost during hospitalization of the conventional group was less than that of the occlusion group (P<0.001). There was no statistical difference in the incidence rate of perioperative complications between the two groups (P>0.05). During the follow-up (15.8±8.8 months), the incidence of complications in the conventional group was higher than that in the occlusion group with a statistical difference (P<0.001).ConclusionCompared with conventional surgery, transthoracic occlusion for VSD via right subaxillary incision has the advantages of smaller incision, shorter operation time, less blood loss, shorter postoperative recovery time and less long-term complications. However, the total hospitalization cost is relatively high, mainly because of the high consumables cost, and the long-term effects still need further comparative observation.
