Clinical Outcomes of Transesophageal Echocardiography-guided Occlusion of Infundibular Ventricular Septal Defect via Minithoracotomy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHUXiao-li , YANGShi-hai , WENLin-lin , TAOShu-guang , HANJian-gang , WANGMing-hai ,  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：

Minithoracotomy; Occluder; Infundibular ventricular septal defect; Transesophageal echocardiography

DOI：

10.7507/1007-4848.20140136

Video：

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Objective To investigate clinical outcomes and safety of transesophageal echocardiography (TEE)-guided occlusion of infundibular ventricular septal defect (VSD) via minithoracotomy. Methods Clinical data of 21 pediatric patients with infundibular VSD who underwent TEE-guided occlusion via minithoracotomy in Children's Hospital of Hebei Province from January to June 2013 were retrospectively analyzed. There were 10 male and 11 female patients with their age of 8-24 (16±8) months and body weight of 9±3 kg. The size of VSD was 4.5±2.5 mm. TEE was used to evaluate the position of the occluder, its influence on the atrioventricular valves and aortic valve, and the presence of residual shunt. Results There was no perioperative death or complication. VSD occlusion was successfully performed in 20 out of 21 patients (95.2%). One patient received conversion to open VSD repair under extracorporeal circulation because VSD size was too big. Mean time of delivery of occluders was 32±16 minutes, the size of the occluders was 5±3 mm, and length of hospital stay was 6-8 days. All the patients were followed up for 3-6 months after discharge. During follow-up, echocardiography showed clear echo and normal position of the occluders, and there was no mild or more severe residual shunt or valvular regurgitation. Conclusion TEE-guided occlusion of infundibular VSD via minithoracotomy is easy to perform and safe with satisfactory clinical outcomes.

Citation： ZHUXiao-li, YANGShi-hai, WENLin-lin, TAOShu-guang, HANJian-gang, WANGMing-hai, WANGJian-ming. Clinical Outcomes of Transesophageal Echocardiography-guided Occlusion of Infundibular Ventricular Septal Defect via Minithoracotomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(4): 478-481. doi: 10.7507/1007-4848.20140136 Copy

1.	吴晓霞, 孙琪, 马东星, 等.嵴内型室间隔缺损介入封堵治疗后超声心动图评价.武警医学, 2011, 22 (2):132-135.
2.	韩勇, 田杰, 刘琴.中国大陆室间隔缺损经导管堵闭与外科手术治疗的Meta分析.中国循证儿科杂志, 2008, 3 (1):15-20.
3.	莫绪明.先天性心脏病的镶嵌治疗.临床小儿外科杂志, 2010, 9 (1):1-3.
4.	赁可, 干昌平, 唐红, 等.经心室穿刺封堵婴幼儿非肌部室间隔缺损39例.中华胸心血管外科杂志, 2008, 24 (6):367-369.
5.	陈俊, 莫绪明, 左维嵩, 等.经食管超声心动图在偏心型封堵器治疗室间隔缺损微创镶嵌术中的应用.中国医学影像学杂志, 2012, 20 (7):524-527, 532.
6.	唐红, 白文娟, 安琪, 等.经食管超声心动图在小儿室间隔缺损微创封堵术中的应用.中国超声医学杂志, 2009, 25 (6):578-580.
7.	李勇, 庞广辉, 张秀辉, 等.经胸小切口封堵治疗室间隔缺损.赣南医学院学报, 2011, 31 (4):543-544.
8.	李俊杰, 张智伟, 钱明阳, 等.应用偏心型和对称型封堵器介入治疗小儿膜周部室间隔缺损的对比研究.中国介入心脏病学杂志, 2009, 17 (6):301-304.
9.	罗艳红, 马小静, 曾祥军, 等.经食管超声心动图监测经胸微创室间隔缺损封堵术.中国超声医学杂志, 2008, 24 (10):945-947.
10.	胡振奎, 吴伟敏, 王强, 等.室间隔缺损不同手术方式的对比研究.实用医学杂志, 2011, 27 (18):3363-3365.
11.	马依彤, 杨毅宁.室间隔缺损介入治疗的适应证、技术和并发症.中国介入心脏病学杂志, 2009, 17 (2):116-118.
12.	邢泉生, 任悦义, 段书华, 等.经胸微创非体外循环下封堵膜部室间隔缺损.中国胸心血管外科临床杂志, 2010, 17 (5):365-369.
13.	张刚成, 沈群山, 尚小珂, 等.经皮导管介入封堵与外科微创封堵治疗室间隔缺损的对比研究.中国介入心脏病学杂志, 2013, 21 (1):17-20.
14.	Geng XJ, Sun SQ, Chen XF, et al. Device closure of perimembranous ventricular septal defects with a minimally invasive technique in 12 patients. Ann Thorac Surg, 2008, 85 (1):192-194.
15.	曾祥军, 陶凉, 陈绪发, 等.经胸骨下段小切口行室间隔封堵的近期疗效评价.中国微创外科杂志, 2009, 9 (5):397-398.
16.	王晖, 杨彦青, 陈华, 等.镶嵌治疗先天性心脏病干下型室间隔缺损.中国现代医学杂志, 2012, 22 (12):83-85.
17.	泮思林, 邢泉生, 荣佑宝, 等.经食管超声心动图在膜周部室间隔缺损镶嵌治疗中的应用.中国超声医学杂志, 2008, 24 (5):459-461.
18.	叶菁菁, 蒋国平, 张泽伟, 等.小儿经食管超声引导室间隔缺损镶嵌治疗的价值.浙江大学学报:医学版, 2009, 38 (3):311-314.
19.	Li F, Chen M, Qiu ZK, 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.	Carminati M, Butera G, Chessa M, et al. Transcatheter closure of congenital ventricular septal defects:results of the European Registry. Eur Heart J, 2007, 28 (19):2361-2368.

1. 吴晓霞, 孙琪, 马东星, 等.嵴内型室间隔缺损介入封堵治疗后超声心动图评价.武警医学, 2011, 22 (2):132-135.
2. 韩勇, 田杰, 刘琴.中国大陆室间隔缺损经导管堵闭与外科手术治疗的Meta分析.中国循证儿科杂志, 2008, 3 (1):15-20.
3. 莫绪明.先天性心脏病的镶嵌治疗.临床小儿外科杂志, 2010, 9 (1):1-3.
4. 赁可, 干昌平, 唐红, 等.经心室穿刺封堵婴幼儿非肌部室间隔缺损39例.中华胸心血管外科杂志, 2008, 24 (6):367-369.
5. 陈俊, 莫绪明, 左维嵩, 等.经食管超声心动图在偏心型封堵器治疗室间隔缺损微创镶嵌术中的应用.中国医学影像学杂志, 2012, 20 (7):524-527, 532.
6. 唐红, 白文娟, 安琪, 等.经食管超声心动图在小儿室间隔缺损微创封堵术中的应用.中国超声医学杂志, 2009, 25 (6):578-580.
7. 李勇, 庞广辉, 张秀辉, 等.经胸小切口封堵治疗室间隔缺损.赣南医学院学报, 2011, 31 (4):543-544.
8. 李俊杰, 张智伟, 钱明阳, 等.应用偏心型和对称型封堵器介入治疗小儿膜周部室间隔缺损的对比研究.中国介入心脏病学杂志, 2009, 17 (6):301-304.
9. 罗艳红, 马小静, 曾祥军, 等.经食管超声心动图监测经胸微创室间隔缺损封堵术.中国超声医学杂志, 2008, 24 (10):945-947.
10. 胡振奎, 吴伟敏, 王强, 等.室间隔缺损不同手术方式的对比研究.实用医学杂志, 2011, 27 (18):3363-3365.
11. 马依彤, 杨毅宁.室间隔缺损介入治疗的适应证、技术和并发症.中国介入心脏病学杂志, 2009, 17 (2):116-118.
12. 邢泉生, 任悦义, 段书华, 等.经胸微创非体外循环下封堵膜部室间隔缺损.中国胸心血管外科临床杂志, 2010, 17 (5):365-369.
13. 张刚成, 沈群山, 尚小珂, 等.经皮导管介入封堵与外科微创封堵治疗室间隔缺损的对比研究.中国介入心脏病学杂志, 2013, 21 (1):17-20.
14. Geng XJ, Sun SQ, Chen XF, et al. Device closure of perimembranous ventricular septal defects with a minimally invasive technique in 12 patients. Ann Thorac Surg, 2008, 85 (1):192-194.
15. 曾祥军, 陶凉, 陈绪发, 等.经胸骨下段小切口行室间隔封堵的近期疗效评价.中国微创外科杂志, 2009, 9 (5):397-398.
16. 王晖, 杨彦青, 陈华, 等.镶嵌治疗先天性心脏病干下型室间隔缺损.中国现代医学杂志, 2012, 22 (12):83-85.
17. 泮思林, 邢泉生, 荣佑宝, 等.经食管超声心动图在膜周部室间隔缺损镶嵌治疗中的应用.中国超声医学杂志, 2008, 24 (5):459-461.
18. 叶菁菁, 蒋国平, 张泽伟, 等.小儿经食管超声引导室间隔缺损镶嵌治疗的价值.浙江大学学报:医学版, 2009, 38 (3):311-314.
19. Li F, Chen M, Qiu ZK, 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. Carminati M, Butera G, Chessa M, et al. Transcatheter closure of congenital ventricular septal defects:results of the European Registry. Eur Heart J, 2007, 28 (19):2361-2368.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical Outcomes of Transesophageal Echocardiography-guided Occlusion of Infundibular Ventricular Septal Defect via Minithoracotomy

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