Closure of atrial septal defect with occluder by minimally invasive and non-extracorporeal circulation ways / 中国微创外科杂志

ABSTRACT

Objective To explore the method of atrial septal defect (ASD)occlusion with occluder by minimally invasive chest ways. Methods 34 patients with ASD were anaesthetized and a 2cm～3cm-long incision was made in the 4th intercostal space of right side of sternum and a Dasdo round or elliptic occluder was placed in the heart.The ASD size and edge in various sections were measured by transesophageal echocardiography,and the type and size of occluder were accordingly selected.Two umbrellas were opened on two sides of ASD under monitoring of echocardiography.After confirming the firm of occluder and no evident atrial shunt,occluder was released,and right atrium and chest were sewed. Results 33 patients with ASD were successfully occluded and one case was failed who received extracorporeal circulation operation.The maximum diameter of ASD was 8～32(19 3?6 3)mm.The shortest edge in variant side was 0 mm to posterior wall of aortea,3.5mm to superior vena cava,6.0mm to inferior vena cava and 6.0mm to the base of mitral valve.The time for closing ASD guided by echocardiography was about 2～3 minutes. Conclusions The placement of ASD occluder through minimal incision of the chest is a new method for the treatment of ASD.It might have wider indications for ASD occlusion.