Comparison of clinical efficacy of minimally invasive transthoracic device closure and traditional repair with ventricular septal defect in infants / 天津医药

ABSTRACT

Objective To compare the treatment effects between minimally invasive transthoracic device closure and traditional surgery on ventricular septal defect (VSD) in infants. Methods Data of 91 infants of VSD, who were less than 6 years old, were retrospectively analyzed from October 2013 to February 2015 in the department of cardiac surgery in Tianjin Chest Hospital. According to the operation mode, patients were divided into minimally invasive transthoracic device closure of VSD (closure) group (n=13) and traditional VSD repair under cardiopulmonary bypass (CPB, repair group, n=78) group. The preoperative cardiac ultrasound was used to determine the type of VSD, the distance from the margin of VSD to aortic and tricuspid valve, pulmonary artery pressure and other cardiac malformations. The intraoperative and postoperative monitoring included blood transfusion volume, valve regurgitation, mechanical ventilation time, intensive care unit (ICU) residence time, hospitalization time and hospitalization cost. The patients were followed up regularly after surgery to collect data including arrhythmia, hemolysis, valve regurgitation and residual shunt of VSD. Results There was no operative mortality in 91 patients. In closure group 1 case was converted to traditional repair surgery under CPB. There were significantly less values in ICU residence time and hospitalization time in closure group than those of the repair group[(13.2±11.7) h vs. (77.2±55.8) h, and (10.0±3.2) d vs. (15.8± 6.7) d, P0.05). Conclusion In the comparison of the recent or short-term clinical curative effect of VSD treatment in infants, the minimally invasive transthoracic VSD device closure is better than the traditional VSD repair treatment. Long term effects need to be further observed and followed up.