Application of TEE in minimal invasive surgical closure of atrial and ventricular septal defects / 中国介入影像与治疗学

ABSTRACT

Objective: To explore the value of TEE-guided surgical minimal invasive closure of atrial septal defects (ASD) and ventricular septal defects (VSD). Methods: Totally 58 patients with ASD and 129 patients with VSD underwent TEE-guided minimal invasive surgical closure. After small chest wall incision, under TEE monitoring, the accurate puncture point of right atrium or right ventricular wall was selected, then arterial hemostatic sheath passed through the gap. Multi-section TEE was used to confirm that the occluder position was suitable. Then the occluder was released when no significant residual shunt and valve complication was observed. Results: Minimal invasive surgical closure was successfully performed in all 58 ASD patients, with small residual shunts were found in 8 cases. Minimal invasive surgical closure of VSD was successfully performed in 114 patients but failed in 15 patients who then underwent open heart repair. Among 114 patients with successfully occluded VSD, 19 patients displayed minimal residual shunt, 2 patients displayed right ventricular outflow tract blood flow velocity increased, and the guide wire smoothly entered the gap in 1 patient after changing the right ventricular wall puncture point. Conclusion: TEE is useful for minimal invasive surgical closure of ASD and VSD, included measuring the size and position, choosing the occluder size, determing operative approach, guiding occluder released and evaluating instant therapeutic effect.