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

ABSTRACT

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.