Clinical analysis of modified suture method in the treatment of perimembranous ventricular septal defect in children / 中国医师进修杂志

ABSTRACT

Objective To observe the clinical efficacy and related complications of modified suture method in treating perimembranous ventricular septal defect(VSD). Methods The clinical data of 110 children with perimembranous VSD were retrospectively analyzed. Among them, 51 cases were treated with conventional suture method (conventional suture group), and 59 cases were treated with modified suture method(modified suture group).The extracorporeal circulation time,intraoperative blood transfusion volume, postoperative drainage volume, total hospital stay and related complications were recorded. The transthoracic echocardiography was performed 1, 6 and 12 months after operation. Results The children successfully completed the operation,and no intraoperative death occurred.The extracorporeal circulation time, intraoperative blood transfusion volume, postoperative drainage volume, total hospital stay and rate of related complications in modified suture group were significantly lower than those in conventional suture group (41.2 ± 9.6) min vs. (52.1 ± 10.6) min, (182.2 ± 42.9) ml vs. (255.3 ± 56.7) ml, (73.2 ± 18.7) ml vs. (102.3 ± 23.5) ml, (12.8 ± 2.5) d vs. (16.1 ± 3.6) d and 13.6% (8/59) vs. 29.4% (15/51), and there were statistical differences (P<0.01 or <0.05). The blood flow velocity of pulmonary valve and blood flow velocity of aortic valve 1,6 and 12 months after operation in modified suture group were significantly better than those in conventional suture group, blood flow velocity of pulmonary valve (113.8 ± 21.4) cm/s vs. (126.5 ± 22.6) cm/s, (104.6 ± 18.2) cm/s vs. (112.3 ± 18.5) cm/s, (102.3 ± 15.8) cm/s vs. (113.8 ± 16.5) cm/s; blood flow velocity of aortic valve(141.9 ± 24.6)cm/s vs.(136.0 ± 25.7)cm/s,(148.3 ± 18.7)cm/s vs.(142.3 ± 20.3)cm/s,(148.8 ± 18.1) cm/s vs. (141.6 ± 18.1) cm/s, and there were statistical differences (P<0.05). Conclusions The modified suture method has the characteristic of short operating time, less blood transfusion and postoperative drainage,and swift recovery.It also can reduce postoperative arrhythmia and residual reflux.