Feasibility of Blocking Congenital Ventricular Septal Defect or Congenital Atrial Septal Defect through Right Subaxillary Incision_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 HANGYong-bin , LIGang , WANGShu-wei , YANGQiao-ling , XUYan-bin , LIANGQiang , LIUJie

Department of Surgery, Cardiacvascular 153 Central Hospital of People's Liberation Army, Zhengzhou 450007, P. R. China;

Corresponding author：

HANGYong-bin, Email: hangyongbin123456@126.com

Keywords：

Ventricular(atrial)septal defect; Minimally invasive transthoracic device closure; Right subaxillary incision; Transesophageal echocardiography

DOI：

10.7507/1007-4848.20160191

Video：

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Objective To evaluate the feasibility and safety of blocking congenital ventricular septal defect or congenital atrial septal defect through the small vertical incision of right subaxillary. Methods We 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. Results There 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. Conclusion Blocking 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.

Citation： HANGYong-bin, LIGang, WANGShu-wei, YANGQiao-ling, XUYan-bin, LIANGQiang, LIUJie. Feasibility of Blocking Congenital Ventricular Septal Defect or Congenital Atrial Septal Defect through Right Subaxillary Incision. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(8): 796-799. doi: 10.7507/1007-4848.20160191 Copy

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2.	Griffin ML, Sullivan ID, Anderson RH, et al. Doubly committed subarterial ventricular septal defect:new morphological criteria with echocardiographic and angiocardiographic correlation. Br Heart J, 1988, 59(4):474-479.
3.	Sim EK, Grignani RT, Wong ML, et al. Outcome of surgical closure of doubly committed subarterial ventricular septal defect. Ann Thorac Surg, 1999, 67(3):736-738.
4.	丁寻实.常用超声介导房间隔缺损封堵方法的优缺点比较.心血管病学进展, 2013, 34(6):823-827.
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7.	Gan CP, An Q, Lin K, et al. Perventricular device closure of ventri-cular septal defects:six months results in 30 young children. Ann Thorac Surg, 2008, 86:142-146.
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10.	Lin K, Zhu D, Tao K, et al. Hybrid perventricular device closure of doubly committed subarterial ventricular septal defects:mid-term results. Catheter Cardiovascular Interv, 2013, 82(3):E225-E232.
11.	Hu S, Yang Y, Wu Q, et al. Results of two different approaches to closure of subaortic ventricular septal defects in children. Eur J Cardiothorac Surg, 2014, 46(4):648-653.
12.	邢泉生, 主编.先天性心脏病经胸微创封堵术.第1版.北京:人民卫生出版社, 2014. 58-95.
13.	朱宪明, 刘志平, 赵龙, 等.经胸小切口房间隔缺损封堵术41例报告.中国微创外科杂志, 2009, 9(2):141-142.
14.	Szkutnik M, Qureshi SA, Kusa J, et al. Use of the amplatzer muscular ventricular septal defect occluder for closure of perimembranous ventricular septal defects. Heart, 2007, 93(3):355-358.
15.	Becker P, Frangini P, Heusser F, et al. New surgical approach to device closure of multiple apical ventricular septal defects. Rev Esp Cardiol, 2004, 57(12):1238-1240.
16.	Crossland DS, Wilkinson JL, Cochrane AD, et al. Initial results of primary device closure of large muscular ventricular septal defects in early infancy using perventricular access. Catheter Cardiovasc Interv, 2008, 72(3):386-391.
17.	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.
18.	Michel BI, 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.
19.	Tao K, Lin K, Shi K, et al. Perventricular device closure of perimem-branous ventricular septal defects in 61 young children:early and midterm follow-up results. J Thorac Cardiovasc Surg, 2010, 140(4):864-870.
20.	苏肇伉.先天性心脏病微创手术的发展趋势.中国胸心血管外科临床杂志, 2005, 12(4):229-231.

1. 徐志伟, 主编.小儿心脏手术学.第2版.北京:人民军医出版社, 2006. 337-350.
2. Griffin ML, Sullivan ID, Anderson RH, et al. Doubly committed subarterial ventricular septal defect:new morphological criteria with echocardiographic and angiocardiographic correlation. Br Heart J, 1988, 59(4):474-479.
3. Sim EK, Grignani RT, Wong ML, et al. Outcome of surgical closure of doubly committed subarterial ventricular septal defect. Ann Thorac Surg, 1999, 67(3):736-738.
4. 丁寻实.常用超声介导房间隔缺损封堵方法的优缺点比较.心血管病学进展, 2013, 34(6):823-827.
5. 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.
6. 陈力, 李俊仁, 刘霞, 等.多平面经食道超声心动图在经胸小切口室间隔缺损封堵术中的应用.医学影像学杂志, 2013, 23(2):200-203.
7. Gan CP, An Q, Lin K, et al. Perventricular device closure of ventri-cular septal defects:six months results in 30 young children. Ann Thorac Surg, 2008, 86:142-146.
8. 李红昕, 张慧, 郭文斌, 等.探条辅助微创室间隔缺损封堵术.中华胸心血管外科杂志, 2011, 27(5):271-272.
9. 张玉展, 李红昕, 黄犇, 等.经胸微创室间隔缺损封堵术的临床研究.河北医药, 2012, 34(18):2746-2747.
10. Lin K, Zhu D, Tao K, et al. Hybrid perventricular device closure of doubly committed subarterial ventricular septal defects:mid-term results. Catheter Cardiovascular Interv, 2013, 82(3):E225-E232.
11. Hu S, Yang Y, Wu Q, et al. Results of two different approaches to closure of subaortic ventricular septal defects in children. Eur J Cardiothorac Surg, 2014, 46(4):648-653.
12. 邢泉生, 主编.先天性心脏病经胸微创封堵术.第1版.北京:人民卫生出版社, 2014. 58-95.
13. 朱宪明, 刘志平, 赵龙, 等.经胸小切口房间隔缺损封堵术41例报告.中国微创外科杂志, 2009, 9(2):141-142.
14. Szkutnik M, Qureshi SA, Kusa J, et al. Use of the amplatzer muscular ventricular septal defect occluder for closure of perimembranous ventricular septal defects. Heart, 2007, 93(3):355-358.
15. Becker P, Frangini P, Heusser F, et al. New surgical approach to device closure of multiple apical ventricular septal defects. Rev Esp Cardiol, 2004, 57(12):1238-1240.
16. Crossland DS, Wilkinson JL, Cochrane AD, et al. Initial results of primary device closure of large muscular ventricular septal defects in early infancy using perventricular access. Catheter Cardiovasc Interv, 2008, 72(3):386-391.
17. 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.
18. Michel BI, 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.
19. Tao K, Lin K, Shi K, et al. Perventricular device closure of perimem-branous ventricular septal defects in 61 young children:early and midterm follow-up results. J Thorac Cardiovasc Surg, 2010, 140(4):864-870.
20. 苏肇伉.先天性心脏病微创手术的发展趋势.中国胸心血管外科临床杂志, 2005, 12(4):229-231.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Feasibility of Blocking Congenital Ventricular Septal Defect or Congenital Atrial Septal Defect through Right Subaxillary Incision

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