Eight Hundred and ninety-one cases with perimembranous ventricular septal defect performed minimally invasive transthoracic device closure / 中国医师杂志

Objective To investigate retrospectively the therapeutic effect and safety of minimally invasive transthoracic device closure of isolated perimembranous ventricular septal defect (PVSD).Methods Eight hundred and ninety-one consecutive patients with PVSD from December 2008 to October 2014 in our hospital were enrolled,which performed minimally invasive transthoracic device closure of ventricular septal defect (VSD),with a 4 ～ 5 cm incision made on the inferior sternum.Under the guide of transthoracic echocardiography (TEE),right ventricular free wall was punctured followed by a delivery sheath threaded into the VSD and the occluder was released thereafter.Whether were there residual shunt and the occluder anchored firmly or not,the position of occluder and the influence on heart valve were re-evaluated intraoperatively by TEE.All patients were followed up prudently post-operation.Echocardiography and electrocardiogram were scheduled according to the protocol.Results Eight hundred and thirty-four cases were successfully occluded.Fifty-seven cases were performed VSD repair operation with cardiopulmonary bypass.The amounts of concentric occluder and eccentric occluder were 703 and 133,respectively.The patients performed minimally invasive transthoracic device closure of VSD had no severe complications after operation.Conclusions Although the short-term and mid-term therapeutic effect of minimally invasive transthoracic device closure of PVSD seem plausible to be definitive,with a favorable prospective application,the long-term follow-up remains to be studied.

Nine cases of children with ventricular septal defect performed super minimally invasive trans intercostal device closure / 中国医师杂志

Objective To introduce the super minimally invasive transintercostal device closure of ventricular septal defect (VSD) and summarize it's therapeutic effect.Methods Nine patiens with VSD from August 2014 to December 2014 in our hospital were enrolled,which performed super minimally invasive transintercostal device closure of VSD.All patients were followed up prudently post-operation.Echocardiography was scheduled according to the protocol.Results All cases were successfully occluded.There was no death case in the peri-operation period and severe complications after operation.Conclusions The super minimally invasive transintercostal device closure of VSD is safe and reliable.

Transesophageal echocardiography guided occlusion of ventricular septal defect via small chest incision: a report of 142 cases / 中国医师杂志

Objective To investigate the experience of microinvasive surgical occlusion of ventricular septal defect (VSD).Methods A total of 142 children with VSD was given microinvasive surgical occlusion from March 2009 to December 2013 at our hospital.There were 90 males and 52 females,the age ranged from 8 months to 11 years,and body weight from 7 kg to 35 kg,and ventricular septal defects were divided into membranous type,film cycle headquarter type,pulmonary valve type,and muscle type.The diameter of VSD was 2 ～ 10 mm.Under general anesthesia,an incision was made in the lower part of sternum or intercostals space,and a special occluder was inserted to close the ostium via right ventricle puncture under the guidance of transesophageal echocardiography.Results A total of 139 cases had successful occluded with a 97.8％ of successful rate,using blocking umbrella 4 ～ 12#,including 25 eccentric umbrella.Two cases were operated under extracorporeal circulation because of aggravated aortic valve insufficiency.One case without handled muscular ventricular septal defect combined atrial septal defect for guide wire pass muscular defect failed.Full set did not have death and third degree A-V block.Conclusions Microinvasive surgical occlusion is easy to handle,operation-time short,and relative broad for the closure of ventricular septal defect.It has a fast recovery and good effectiveness with a beautiful outlook and safety.

The clinical observation of two minimally invasive interventions for patients with hypertensive intracerebral hemorrhage / 中国医师杂志

Objective Soft and hard channel minimally invasive interventions for patients with hypertensive intracerebral hemorrhage have been used for many years. A retrospective study was performed to evaluate the superiority of these two methods. Methods 122 patients with hypertensive intracerebral hemorrhage were included in this retrospective study, 64 cases in soft channel group and 58 cases in hard channel group. The clinical effects were compared; catheter retention time and complications of the minimally invasive surgery were also observed in these two groups. Results In soft channel group, NIHSS before the treatment was 18.05±7.77, and NIHSS after the treatment was 7.57±4.68. The mortality was 17.19%. The catheter retention time in hematoma puncture was (4.35±1.56)days, and the catheter retention time in ventricle puncture was (7.67±2.37)days. There were 4 cases of rebleeding and 3 cases of intracranial infection. In hard channel group, NIHSS before the treatment was 18.38±9.02, and NIHSS after the treatment was 8.02±4.84. The mortality was 20.69%. The catheter retention time in hematoma puncture was (4.07±1.49)days, and the catheter retention time in ventricle puncture was (8.17±2.55)days. There were 9 cases of rebleeding and 2 cases of intracranial infection. The differences were not statistically significant (P＞0.05). Conclusions Soft and hard channel minimally invasive interventions of hypertensive cerebral hemorrhage have the same clinical value.