关键词: 心脏缺损, 先天性, 室间隔缺损, 心脏外科手术, 镶嵌治疗

Abstract: Objective To discuss the clinical efficacy of Hybrid therapy in repairing muscular ventricular septal defect (mVSD) associated with additional congenital heart disease in children. Methods The clinical data of 18 patients (9 males and 9 females) admitted to our hospital from December 2012 to December 2016 were retrospectively analyzed. The mainly additional congenital heart diseases were tetralogy of fallot, coarctation of aorta, complete transposition of great arteries, double outlet right ventricle, mitral valve cleft. All of the patients were treated with corrective surgeries of Hybrid therapy under direct supervision. Results Four patients died through the operation. One patient died of postoperative infection, 1 patient died of the complex malformation, which wasn′ t repaired, 1 patient died of mitral valve damage for occluder device replacement, 1 patient died of arrhythmia with unknown reason. One patient received non planned reoperation because of the huge membranous ventricular septal defect for the first stage surgery, in which no mVSD was found. All the rest patients were completed their first stage treatment and discharged from hospital. During the followed ups (1 month to 5 years), no patient died. The occluder devices were in correct position in 14 patients, no residual shunt was found in 12 cases. The cardiac function was normal in 13 cases [ejection fraction (EF)=0.63±0.05]. Conclusion It is safe and effective for the treatment of mVSD using Hybrid therapy, which is especially suitable for patients with complex cardiac malformations and patients with complicated vascular situation.

Key words: heart defects, congenital, heart septal defects, ventricular, cardiac surgical procedures, Hybrid therapy