Clinical results of ultrasound-guided thoracoscopic atrial septal defect closure_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

GONG Dingxu , ZHENG Zhe , ZHAO Guangzhi , XIE Yongquan , ZHANG Fengwen ,  PAN Xiangbin

Department of Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, P.R.China;

Corresponding author：

PAN Xiangbin, Email: xiangbin428@hotmail.com

Keywords：

Atrial septal defect; thoracoscopy; ultrasound-guided intervention; transcatheter closure

DOI：

10.7507/1007-4848.201801011

Video：

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Objective To analyze the safety and effectiveness of ultrasound-guided thoracoscopic atrial septal defect (ASD) closure. Methods We prospectively collected the clinical data of 12 patients with ASD treated by ultrasound-guided thoracoscopic ASD closure in Fuwai Hospital from January to September 2017. The characteristics of the patients' ASD and operation, operation safety and effectiveness, postoperative complications and follow-up results were analyzed. Results Among the 12 patients, 10 were successfully treated with ultrasound-guided thoracoscopic ASD closure. Two patients switched to ASD repair under thoracoscopy-assisted cardiopulmonary bypass. The size of the ASD was 17-40 (27.22±8.97) mm and the size of the occluder was 36 (30-42) mm. The average postoperative length of hospital stay was 6 days. There were no complications such as arrhythmia, bleeding and pericardial effusion after operation. The average follow-up was 6 (3-10) months after the operation. During the follow-up, no Ⅲ-degree conduction block, occluder dislocation, residual shunt or cardiac pericardial effusion was found. Conclusion Ultrasound-guided thoracoscopic ASD closure is a minimally invasive, safe and effective treatment. This technique provides a new minimally invasive surgical option for patients with large defect diameter and poor edge condition.

Citation： GONG Dingxu, ZHENG Zhe, ZHAO Guangzhi, XIE Yongquan, ZHANG Fengwen, PAN Xiangbin. Clinical results of ultrasound-guided thoracoscopic atrial septal defect closure. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(6): 462-465. doi: 10.7507/1007-4848.201801011 Copy

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3.	潘湘斌, 张凤文, 逄坤静, 等. 单纯超声心动图引导下房间隔缺损介入封堵术的临床研究. 中国循环杂志, 2014, 29(z1): 76.
4.	周连生, 段大为, 韩世发, 等.电视胸腔镜辅助下房间隔缺损修补术36例报告. 局解手术学杂志, 2008, 17(5): 318-319.
5.	祁长敏, 高虹. 房间隔缺损三种治疗方法的比较研究. 四川医学, 2009, 30(6): 844-846.
6.	Mulukutla V, Qureshi AM, Pignatelli R, et al. Predictive factors for patients undergoing ASD device occlusion who " crossover” to surgery. Pediatr Cardiol, 2018, 39(3): 445-449.
7.	O’Byrne ML, Shinohara RT, Grant EK, et al. Increasing propensity to pursue operative closure of atrial septal defects following changes in the instructions for use of the Amplatzer Septal Occluder device: An observational study using data from the Pediatric Health Information Systems database. Am Heart J, 2017, 192: 85-97.
8.	Kim HR, Jung SH, Park JJ, et al. Risk analysis of the long-term outcomes of the surgical closure of secundum atrial septal defects. Korean J Thorac Cardiovasc Surg, 2017, 50(2): 78-85.
9.	戴汝平, 刘延玲, 张戈军, 等. 应用Amplatzer封堵器介入治疗房间隔缺损疗效评价(附60例报告). 中华心血管病杂志, 2000, 28(2): 87-91.
10.	Yoo BW, Kim JO, Eun LY, et al. Time course of the changes in right and left ventricle function and associated factors after transcatheter closure of atrial septal defects. Congenit Heart Dis, 2018, 13(1): 131-139.
11.	李守军. 先天性心脏病的单纯超声引导下经皮介入治疗现状与展望. 中国循环杂志, 2015, 30(11): 1033-1034.
12.	杨秋蓝, 张燕搏, 潘湘斌, 等. 经胸微创封堵术治疗先天性心脏病临床分析. 中华实用诊断与治疗杂志, 2016, 30(4): 363-365.
13.	Chen Q, Cao H, Zhang GC, et al. Midterm follow-up of transthoracic device closure of an atrial septal defect using the very large domestic occluder (44-48 mm), a single Chinese cardiac center experience. J Cardiothorac Surg, 2017, 12(1): 74.
14.	Chiu KM, Chen RJ. Videoscope-assisted cardiac surgery. J Thorac Dis, 2014, 6(1): 22-30.
15.	陈海生, 程云阁, 钟焕清, 等. 胸腔镜与开胸手术治疗先天性心脏病的疗效比较. 中国微创外科杂志, 2005, 5(8): 634-635.
16.	潘湘斌. 超声引导经皮介入治疗结构性心脏病的探索和发展前景. 中国胸心血管外科临床杂志, 2018, 25(5): 359-361.

1. Geva T, Martins JD, Wald RM. Atrial septal defects. Lancet, 2014, 383(9932): 1921-1932.
2. O’Byrne ML, Kennedy KF, Rome JJ, et al. Variation in practice patterns in device closure of atrial septal defects and patent ductus arteriosus: An analysis of data from the IMproving Pediatric and Adult Congenital Treatment (IMPACT) registry. Am Heart J, 2018, 196: 119-130.
3. 潘湘斌, 张凤文, 逄坤静, 等. 单纯超声心动图引导下房间隔缺损介入封堵术的临床研究. 中国循环杂志, 2014, 29(z1): 76.
4. 周连生, 段大为, 韩世发, 等.电视胸腔镜辅助下房间隔缺损修补术36例报告. 局解手术学杂志, 2008, 17(5): 318-319.
5. 祁长敏, 高虹. 房间隔缺损三种治疗方法的比较研究. 四川医学, 2009, 30(6): 844-846.
6. Mulukutla V, Qureshi AM, Pignatelli R, et al. Predictive factors for patients undergoing ASD device occlusion who " crossover” to surgery. Pediatr Cardiol, 2018, 39(3): 445-449.
7. O’Byrne ML, Shinohara RT, Grant EK, et al. Increasing propensity to pursue operative closure of atrial septal defects following changes in the instructions for use of the Amplatzer Septal Occluder device: An observational study using data from the Pediatric Health Information Systems database. Am Heart J, 2017, 192: 85-97.
8. Kim HR, Jung SH, Park JJ, et al. Risk analysis of the long-term outcomes of the surgical closure of secundum atrial septal defects. Korean J Thorac Cardiovasc Surg, 2017, 50(2): 78-85.
9. 戴汝平, 刘延玲, 张戈军, 等. 应用Amplatzer封堵器介入治疗房间隔缺损疗效评价(附60例报告). 中华心血管病杂志, 2000, 28(2): 87-91.
10. Yoo BW, Kim JO, Eun LY, et al. Time course of the changes in right and left ventricle function and associated factors after transcatheter closure of atrial septal defects. Congenit Heart Dis, 2018, 13(1): 131-139.
11. 李守军. 先天性心脏病的单纯超声引导下经皮介入治疗现状与展望. 中国循环杂志, 2015, 30(11): 1033-1034.
12. 杨秋蓝, 张燕搏, 潘湘斌, 等. 经胸微创封堵术治疗先天性心脏病临床分析. 中华实用诊断与治疗杂志, 2016, 30(4): 363-365.
13. Chen Q, Cao H, Zhang GC, et al. Midterm follow-up of transthoracic device closure of an atrial septal defect using the very large domestic occluder (44-48 mm), a single Chinese cardiac center experience. J Cardiothorac Surg, 2017, 12(1): 74.
14. Chiu KM, Chen RJ. Videoscope-assisted cardiac surgery. J Thorac Dis, 2014, 6(1): 22-30.
15. 陈海生, 程云阁, 钟焕清, 等. 胸腔镜与开胸手术治疗先天性心脏病的疗效比较. 中国微创外科杂志, 2005, 5(8): 634-635.
16. 潘湘斌. 超声引导经皮介入治疗结构性心脏病的探索和发展前景. 中国胸心血管外科临床杂志, 2018, 25(5): 359-361.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical results of ultrasound-guided thoracoscopic atrial septal defect closure

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