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.	张亚飞,王克学,王岩青,等.经胸微创室间隔缺损封堵术50例疗效分析.心肺血管病杂志,2014,33(3):395-401.
2.	邢泉生,武钦.经胸微创非体外循环下封堵室间隔缺损的研究进展.中华胸心血管外科杂志,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.	中国医师协会心血管内科分会先心病工作委员会.常见先天性心脏病介入治疗中国专家共识.介入放射学杂志,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,庄忠云,泮思林,等.应用新型输送系统经胸微创封堵膜周部室间隔缺损.中华实验外科杂志,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.	郭俊晓,刘志平,朱宪明,等.经胸微创室间隔缺损封堵术38例临床分析.中国胸心血管外科临床杂志,2013,20(6):728-730.
15.	李小波,万亚红,邬云,等.低龄低体重患儿经胸小切口封堵膜周部室间隔缺损的策略及早期疗效.中国微创外科杂志,2012,12(11):964-968.
16.	中国医师协会心血管外科医师分会.经胸微创室间隔缺损封堵术中国专家共识.中华胸心血管外科杂志,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.	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.
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. 张亚飞,王克学,王岩青,等.经胸微创室间隔缺损封堵术50例疗效分析.心肺血管病杂志,2014,33(3):395-401.
2. 邢泉生,武钦.经胸微创非体外循环下封堵室间隔缺损的研究进展.中华胸心血管外科杂志,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. 中国医师协会心血管内科分会先心病工作委员会.常见先天性心脏病介入治疗中国专家共识.介入放射学杂志,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,庄忠云,泮思林,等.应用新型输送系统经胸微创封堵膜周部室间隔缺损.中华实验外科杂志,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. 郭俊晓,刘志平,朱宪明,等.经胸微创室间隔缺损封堵术38例临床分析.中国胸心血管外科临床杂志,2013,20(6):728-730.
15. 李小波,万亚红,邬云,等.低龄低体重患儿经胸小切口封堵膜周部室间隔缺损的策略及早期疗效.中国微创外科杂志,2012,12(11):964-968.
16. 中国医师协会心血管外科医师分会.经胸微创室间隔缺损封堵术中国专家共识.中华胸心血管外科杂志,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. 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.
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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