Tianjin Med J ›› 2016, Vol. 44 ›› Issue (7): 898-901.doi: 10.11958/20160038

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

jian chen1,LIU Jianshi   

  1. 1 Department of Cardiothoracic Surgery, Binhai New Area Dagang Hospital of Tianjin, Tianjin 300270, China; 2 Department of Cardiac Surgery, Tianjin Chest Hospital
  • Received:2016-01-27 Revised:2016-06-22 Published:2016-07-15 Online:2016-07-15
  • Contact: LIU Jianshi E-mail:jianshiliu@aliyun.com

Abstract: Abstract:Objective Comparison of the treatment effects of minimally invasive transthoracic device closure and traditional surgery in infant with VSD. Methods Retrospective analysis the data of 91 cases of VSD in infant under 6 years old 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 CPB (repair) group (n=78). In 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. Intraoperative and postoperative monitoring included blood transfusion volume, valve regurgitation, mechanical ventilation time, ICU residence time, hospitalization time and cost, etc.. The patients were followed up for 12~18 months to collect arrhythmia, hemolysis,valve regurgitation and residual shunt of VSD. Results There were no operative mortality in 91 patients. In closure group 1 case were converted to traditional repair under CPB. The closure group was significantly less than that of the repair group in the time of ICU residence and hospitalization[(13.2±11.7) h vs. (77.2±55.8) h,(10.0±3.2) d vs. (15.8±6.7) d,P<0.05]. In closure group 1 case(7.7%)underwent median sternotomy and CPB,all cases in repair group were median sternotomy and CPB. The infusion amount of suspended red blood cells and plasma and the time of mechanical ventilation the closure group were less than those in the repair group (P<0.05). There was no significant difference between the 2 groups in the cost of hospitalization and the incidence of complications during early postoperative and the follow-up period, including arrhythmia, VSD residual shunt, valve regurgitation, hemolysis, etc.(P>0.05). Conclusion In the comparison of the recent clinical curative effect of VSD treatment in infants , the minimally invasive transthoracic VSD device closure is better than the traditional VSD repair. Long term effects need to be further observed and followed up.

Key words: Key words:heart defects, congenital, heart septal defects, ventricular, surgical procedures, minimally invasive, infant, treatment