Hybrid Perventricular Closure for Pediatric Patients with Muscular Ventricular Septal Defect: Experience from West China Hospital_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHUDa ¹ , LINKe ¹ , FENGYuan ² , ANQi ¹ ,  TANGMeng-lin ¹

1. Department of Cardiovascular Surgery, Pediatric Heart Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. Department of Cardiology, Pediatric Heart Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

TANGMeng-lin, Email: menglin_tang@163.com

Keywords：

Congenital heart disease; Muscular ventricular septal defect; Perventricular device closure; Hybrid procedure

DOI：

10.7507/1007-4848.20150033

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the efficacy and safety of hybrid perventricular device closure (PVDC) for the treatment of muscular ventricular septal defect (MVSD) in pediatric patients. Methods We retrospectively analyzed clinical data of 35 pediatric patients with MVSD who received hybrid PVDC in West China Hospital between 2009 and 2012. There were 16 males and 19 females with their median age of 3.9 years (range, 1 month to 7 years). There were 10 patients with single MVSD, 12 patients with multiple MVSD, 6 patients with other congenital heart defects, and 7 patients with post-surgical residual MVSD. Results Among the 35 patients, immediate complete closure was achieved in 28 (80.0%) patients. Residual shunt was noted in 7 (20.0%) patients. Median device size was 5 mm. Cardiopulmonary bypass was avoided in 19 patients. Two (5.7%) patients died postoperatively due to postoperative heart failure resulted from complex congenital heart defect. All survival patients were followed up for a mean duration of 6 months, and there was no late death. Thirty-one (93.9%) patients had good positioning of the closure devices but no residual shunt. Small residual shunt at the apex was noted in 2 (6.1%) patients. Conclusion Hybrid PVDC is an effective treatment for MVSD with relatively high successful rate but low mortality and morbidity, and its short-term results are satisfactory.

Citation： ZHUDa, LINKe, FENGYuan, ANQi, TANGMeng-lin. Hybrid Perventricular Closure for Pediatric Patients with Muscular Ventricular Septal Defect: Experience from West China Hospital. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(2): 118-121. doi: 10.7507/1007-4848.20150033 Copy

1.	Kouchoukos NT, Chief editor. Kirklin/Barratt-Boyes Cardiac Surgery:Morphology, Diagnostic Criteria, Natural History, Techniques, Results, and Indications. 3rd ed, London:Churchill Livingstone, 2003. 850-909.
2.	Kapoor L, Gan MD, Das MB, et al. Technique to repair multiple muscular ventricular septal defects. J Thorac Cardiovasc Surg, 1999, 117(2):402-404.
3.	高波涛, 郑景浩, 张海波, 等.婴幼儿多发性室间隔缺损中肌部室间隔缺损的外科治疗.中国胸心血管外科临床杂志, 2013, 20(3):260-263.
4.	Knauth AL, Lock JE, Perry SB, et al. Transcatheter device closure of congenital and postoperative residual ventricular septal defects. Circulation, 2004, 110(5):501-507.
5.	Amin Z, Berry JM, Foker JE, et al. Intraoperative closure of muscular ventricular septal defect in a canine model and application of the technique in a baby. J Thorac Cardiovasc Surg, 1998, 115(6):1374-1376.
6.	Amin Z, Cao QL, Hijazi ZM. Closure of muscular ventricular septal defects:Transcatheter and hybrid techniques. Catheter Cardiovasc Inter, 2008, 72(1):102-111.
7.	Diab KA, Cao QL, Mora BN, et al. Device closure of muscular ventricular septal defects in infants less than one year of age using the Amplatzer devices:feasibility and outcome. Catheter Cardiovasc Interv, 2007, 70(1):90-97.
8.	Holzer R, Balzer D, Cao Ql, et al. Device closure of muscular ventricular septal defects using the Amplatzer muscular ventricular septal defect occluder:immediate and mid-term results of a U. S.registry. J Am Coll Cardiol, 2004, 43(7):1257-1263.
9.	Michel-Behnke I, Ewert P, Koch A, et al. Device closure of ventricular septal defects by hybrid procedures:a multicenter retrospective study. Catheter Cardiovasc Inter, 2011, 77(2):242-251.
10.	Laussen PC, Hansen DD, Perry SB, et al. Transcatheter closure of ventricular septal defects:hemodynamic instability and anesthetic management. Anesth Analg, 1995, 80(6):1076-1082.
11.	沈晟, 贾兵, 陈张根, 等.经胸杂交封堵技术治疗小儿肌部室间隔缺损18例.临床小儿外科杂志, 2013, 12(2):132-134.
12.	Stellin G, Padalino M, Milanesi O, et al. Surgical closure of apical ventricular septal defects through a right ventricular apical infundibulotomy. Ann Thorac Surg, 2000, 69(2):597-601.
13.	Ootaki Y, Yamaguchi M, Yoshimura N, et al. Surgical management of trabecular ventricular septal defects:the sandwich technique. J Thorac Cardiovasc Surg, 2003, 125(3):508-512.
14.	Serraf A, Lacour-Gayet F, Bruniaux J, et al. Surgical management of isolated multiple ventricular septal defects. Logical approach in 130 cases. J Thorac Cardiovasc Surg, 1992, 103(3):437-443.
15.	Black MD, Shukla V, RAO V, et al. Repair of isolated multiple muscular ventricular septal defects:the septal obliteration technique. Ann Thorac Surg, 2000, 70(1):106-110.
16.	Mace L, Dervanian P, Le Bret E, et al. "Swiss cheese" septal defects:surgical closure using a single patch with intermediate fixings. Ann Thorac Surg, 1999, 67(6):1754-1759.
17.	Kitagawa T, Durham LA, Mosca RS, et al. Techniques and results in the management of multiple ventricular septal defects. J Thorac Cardiovasc Surg, 1998, 115(4):848-856.
18.	Haponiuk I, Chojnicki M, Jaworski R, et al. Hybrid technique for muscular ventricular septal defect closure. J Card Surg, 2013, 28(4):453-455.
19.	Pedra CA, Pedra SR, Chaccur P, et al. Perventricular device closure of congenital muscular ventricular septal defects. Expert Rev Cardiovasc Ther, 2010, 8(5):663-674.

1. Kouchoukos NT, Chief editor. Kirklin/Barratt-Boyes Cardiac Surgery:Morphology, Diagnostic Criteria, Natural History, Techniques, Results, and Indications. 3rd ed, London:Churchill Livingstone, 2003. 850-909.
2. Kapoor L, Gan MD, Das MB, et al. Technique to repair multiple muscular ventricular septal defects. J Thorac Cardiovasc Surg, 1999, 117(2):402-404.
3. 高波涛, 郑景浩, 张海波, 等.婴幼儿多发性室间隔缺损中肌部室间隔缺损的外科治疗.中国胸心血管外科临床杂志, 2013, 20(3):260-263.
4. Knauth AL, Lock JE, Perry SB, et al. Transcatheter device closure of congenital and postoperative residual ventricular septal defects. Circulation, 2004, 110(5):501-507.
5. Amin Z, Berry JM, Foker JE, et al. Intraoperative closure of muscular ventricular septal defect in a canine model and application of the technique in a baby. J Thorac Cardiovasc Surg, 1998, 115(6):1374-1376.
6. Amin Z, Cao QL, Hijazi ZM. Closure of muscular ventricular septal defects:Transcatheter and hybrid techniques. Catheter Cardiovasc Inter, 2008, 72(1):102-111.
7. Diab KA, Cao QL, Mora BN, et al. Device closure of muscular ventricular septal defects in infants less than one year of age using the Amplatzer devices:feasibility and outcome. Catheter Cardiovasc Interv, 2007, 70(1):90-97.
8. Holzer R, Balzer D, Cao Ql, et al. Device closure of muscular ventricular septal defects using the Amplatzer muscular ventricular septal defect occluder:immediate and mid-term results of a U. S.registry. J Am Coll Cardiol, 2004, 43(7):1257-1263.
9. Michel-Behnke I, Ewert P, Koch A, et al. Device closure of ventricular septal defects by hybrid procedures:a multicenter retrospective study. Catheter Cardiovasc Inter, 2011, 77(2):242-251.
10. Laussen PC, Hansen DD, Perry SB, et al. Transcatheter closure of ventricular septal defects:hemodynamic instability and anesthetic management. Anesth Analg, 1995, 80(6):1076-1082.
11. 沈晟, 贾兵, 陈张根, 等.经胸杂交封堵技术治疗小儿肌部室间隔缺损18例.临床小儿外科杂志, 2013, 12(2):132-134.
12. Stellin G, Padalino M, Milanesi O, et al. Surgical closure of apical ventricular septal defects through a right ventricular apical infundibulotomy. Ann Thorac Surg, 2000, 69(2):597-601.
13. Ootaki Y, Yamaguchi M, Yoshimura N, et al. Surgical management of trabecular ventricular septal defects:the sandwich technique. J Thorac Cardiovasc Surg, 2003, 125(3):508-512.
14. Serraf A, Lacour-Gayet F, Bruniaux J, et al. Surgical management of isolated multiple ventricular septal defects. Logical approach in 130 cases. J Thorac Cardiovasc Surg, 1992, 103(3):437-443.
15. Black MD, Shukla V, RAO V, et al. Repair of isolated multiple muscular ventricular septal defects:the septal obliteration technique. Ann Thorac Surg, 2000, 70(1):106-110.
16. Mace L, Dervanian P, Le Bret E, et al. "Swiss cheese" septal defects:surgical closure using a single patch with intermediate fixings. Ann Thorac Surg, 1999, 67(6):1754-1759.
17. Kitagawa T, Durham LA, Mosca RS, et al. Techniques and results in the management of multiple ventricular septal defects. J Thorac Cardiovasc Surg, 1998, 115(4):848-856.
18. Haponiuk I, Chojnicki M, Jaworski R, et al. Hybrid technique for muscular ventricular septal defect closure. J Card Surg, 2013, 28(4):453-455.
19. Pedra CA, Pedra SR, Chaccur P, et al. Perventricular device closure of congenital muscular ventricular septal defects. Expert Rev Cardiovasc Ther, 2010, 8(5):663-674.

Previous Article
Concomitant Surgical Treatment for Patients with both Coronary Artery Disease and Lung Cancer
Next Article
罕见右心房浸润性脂肪瘤合并右心房血栓一例

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Hybrid Perventricular Closure for Pediatric Patients with Muscular Ventricular Septal Defect: Experience from West China Hospital

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content