Influencing factors and outcomes of atrial septal defect or ventricular septal defect occlusion guided by echocardiography_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 LIU Jian , TANG Xiancheng , HUANG Jixiu , LIN Xiaobin

Department of Cardiac Surgery, People's Hospital of Jianyang City, Jianyang, 641499, Sichuan, P.R.China;

Corresponding author：

LIU Jian, Email: liujiun688@sina.com

Keywords：

Atrial septal defect; ventricular septal defect; echocardiography; minimally invasive; occluder

DOI：

10.7507/1007-4848.201801052

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To analyze the influencing factors and outcomes of atrial septal defect (ASD) and ventricular septal defect (VSD) occlusion guided by echocardiography. Methods We retrospectively analyzed the clinical data of 188 patients receiving transthoracic and percutaneous transcatheter closure of ASD and VSD from July 2009 to July 2017 in our department, including 74 males and 114 females, aged 13.48±13.53 years ranging from 1 to 65 years. Results Fifty-three ASD patients accepted transthoracic closure surgery, of whom 4 patients were difficult to close and 6 patients failed to close; 24 patients underwent percutaneous transcatheter ASD occlusion surgery, of whom 3 were difficult to close and 1 failed in occlusion; 108 VSD patients implemented transthoracic closure surgery, of whom 10 patients were difficult to close and 5 patients failed in closure; 9 VSD patients underwent percutaneous transcatheter closure, of whom 5 failed and then was converted to transthoracic closure. Our study showed that too large or too small aperture was the independent risk factor. Two kinds of closure surgery had their own advantages and disadvantages. The special type of VSD was the influencing factor of transthoracic closure. Conclusion When the ASD diameter≥25 mm, transthoracic closure is the best choice to avoid the use of large occluder. When the ASD diameter<25 mm, percutaneous closure surgery is the best choice. When the ASD diameter≥35 mm, it is best to give up the closure operation. Technical improvements can significantly raise the closure success rate of the subarterial VSD. For the entry diameter>10 mm and membranous aneurysm with multi-break, occlusion surgery should be avoided in VSD.

Citation： LIU Jian, TANG Xiancheng, HUANG Jixiu, LIN Xiaobin. Influencing factors and outcomes of atrial septal defect or ventricular septal defect occlusion guided by echocardiography. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(12): 1060-1063. doi: 10.7507/1007-4848.201801052 Copy

1.	Guo QK, Lu ZQ, Cheng SF, et al. Off-pump occlusion of transthoracic minimally invasive surgery (OPOTTMIS) on simple congenital heart diseases (ASD, VSD and PDA) attached consecutive 210 cases report: a single institute experience. J Cardiothorac Surg, 2011, 6(1): 48-57.
2.	Michel-Behnke I, 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.
3.	国家卫生和计划生育委员会经外科途径心血管疾病介入诊疗专家工作组. 常见心血管疾病经外科途径进行介入诊疗的专家共识. 中国循环杂志, 2017, 32(2): 105-119.
4.	刘健, 黄击修, 林小彬, 等. 室间隔缺损经胸小切口封堵的应用价值. 心血管外科杂志(电子版), 2014, 3(1): 26-28.
5.	李伟, 顾伟礼, 励峰, 等. 微创经胸小切口室间隔缺损封堵术的临床应用. 中国胸心血管外科临床杂志, 2016, 23(2): 191-193.
6.	潘湘斌, 逄坤静, 欧阳文斌, 等. 单纯超声心动图引导下经皮室间隔缺损封堵术的应用研究. 中国循环杂志, 2015, 30(8): 774-776.
7.	刘志平, 赵龙, 李淑珍, 等. 微创经胸小切口室间隔缺损封堵术临床分析. 中国心血管病研究, 2017, 15(1): 26-29.
8.	邢泉生. 如何理性看待先天性心脏病经胸微创封堵技术的迅速发展. 国际心血管病杂志, 2016, 43(3): 129-132.
9.	潘湘斌, 欧阳文斌, 王首正, 等. 单纯超声引导下经颈静脉室间隔缺损封堵术的探索研究. 中国循环杂志, 2015, 30(12): 1204-1207.
10.	吴文海, 王清木, 颜如玉, 等. 超声心动图引导经胸小切口室间隔缺损封堵术临床分析. 中外医疗, 2017, 36(12): 1-3, 15.
11.	王广阔, 蔡丽霞, 张志刚, 等. 食管超声引导经胸室间隔缺损封堵术的临床体会. 中国心血管病研究, 2016, 14(12): 1127-1129.
12.	何小梅, 郭学佳, 张宁, 等. 超声监护下国产器材封堵房间隔缺损的心导管法与经胸小切口法对比分析. 中南大学学报(医学版), 2017, 42(6): 629-634.
13.	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.
14.	Lin K, Zhu D, Tao K, et al. Hybrid perventricular device closure of doubly committed subarterial ventricular septal defects: mid-term results. Catheter Cardiovasc Interv, 2013, 82(3): E225-E232.
15.	Pan S, Xing Q, Cao Q, et al. Perventricular device closure of doubly committed subarterial ventral septal defect through left anterior minithoracotomy on beating hearts. Ann Thorac Surg, 2012, 94(6): 2070-2075.
16.	马伦超, 陆国梁, 杨超, 等. 左胸骨旁小切口封堵分流方向偏向流出道的室间隔缺损 15 例. 中国胸心血管外科临床杂志, 2016, 23(3): 304-306.

1. Guo QK, Lu ZQ, Cheng SF, et al. Off-pump occlusion of transthoracic minimally invasive surgery (OPOTTMIS) on simple congenital heart diseases (ASD, VSD and PDA) attached consecutive 210 cases report: a single institute experience. J Cardiothorac Surg, 2011, 6(1): 48-57.
2. Michel-Behnke I, 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.
3. 国家卫生和计划生育委员会经外科途径心血管疾病介入诊疗专家工作组. 常见心血管疾病经外科途径进行介入诊疗的专家共识. 中国循环杂志, 2017, 32(2): 105-119.
4. 刘健, 黄击修, 林小彬, 等. 室间隔缺损经胸小切口封堵的应用价值. 心血管外科杂志(电子版), 2014, 3(1): 26-28.
5. 李伟, 顾伟礼, 励峰, 等. 微创经胸小切口室间隔缺损封堵术的临床应用. 中国胸心血管外科临床杂志, 2016, 23(2): 191-193.
6. 潘湘斌, 逄坤静, 欧阳文斌, 等. 单纯超声心动图引导下经皮室间隔缺损封堵术的应用研究. 中国循环杂志, 2015, 30(8): 774-776.
7. 刘志平, 赵龙, 李淑珍, 等. 微创经胸小切口室间隔缺损封堵术临床分析. 中国心血管病研究, 2017, 15(1): 26-29.
8. 邢泉生. 如何理性看待先天性心脏病经胸微创封堵技术的迅速发展. 国际心血管病杂志, 2016, 43(3): 129-132.
9. 潘湘斌, 欧阳文斌, 王首正, 等. 单纯超声引导下经颈静脉室间隔缺损封堵术的探索研究. 中国循环杂志, 2015, 30(12): 1204-1207.
10. 吴文海, 王清木, 颜如玉, 等. 超声心动图引导经胸小切口室间隔缺损封堵术临床分析. 中外医疗, 2017, 36(12): 1-3, 15.
11. 王广阔, 蔡丽霞, 张志刚, 等. 食管超声引导经胸室间隔缺损封堵术的临床体会. 中国心血管病研究, 2016, 14(12): 1127-1129.
12. 何小梅, 郭学佳, 张宁, 等. 超声监护下国产器材封堵房间隔缺损的心导管法与经胸小切口法对比分析. 中南大学学报(医学版), 2017, 42(6): 629-634.
13. 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.
14. Lin K, Zhu D, Tao K, et al. Hybrid perventricular device closure of doubly committed subarterial ventricular septal defects: mid-term results. Catheter Cardiovasc Interv, 2013, 82(3): E225-E232.
15. Pan S, Xing Q, Cao Q, et al. Perventricular device closure of doubly committed subarterial ventral septal defect through left anterior minithoracotomy on beating hearts. Ann Thorac Surg, 2012, 94(6): 2070-2075.
16. 马伦超, 陆国梁, 杨超, 等. 左胸骨旁小切口封堵分流方向偏向流出道的室间隔缺损 15 例. 中国胸心血管外科临床杂志, 2016, 23(3): 304-306.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Influencing factors and outcomes of atrial septal defect or ventricular septal defect occlusion guided by echocardiography

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content