Efficacy of minimally invasive transthoracic closure of atrial and ventricular septal defects_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

MENG Xiongwei ¹ ,  YANG Siyuan ² , HU Xuanyi ² , JIANG Tian ²

1. Guizhou Medical University, Guiyang, 550004, P.R.China;
2. Department of Cardiac Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, 550004, P.R.China;

Corresponding author：

YANG Siyuan, Email: 15772955@qq.com

Keywords：

Atrial septal defect; ventricular septal defect; minimally invasive; surgical occlusion procedure; complication

DOI：

10.7507/1007-4848.201708049

Video：

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Objective To evaluate the efficacy and safety of transthoracic minimally invasive occlusion operation for the treatment of congenital atrial and ventricular septal defects. Methods The clinical data of 88 patients who underwent surgical occlusion operation from December 2015 to February 2017 were summarized. There were 52 males and 36 females, aged 6.8±7.5 years ranging from 1.6 to 24.0 years. All the patients were followed up by ultrasound and electrocardiogram at postoperative 3, 6 and 12 months. The efficacy of minimally invasive thoracotomy was analyzed by statistical methods. Results The patients were followed up for 3-15 (6.8±2.3) months, and the follow-up rate was 92.0%. Ultrasound showed occluder fixed well and no residual shunt, valve regurgitation, thrombosis or other complications occurred. The heart was reduced, the ejection fraction was greater than 55%, and heart function rating for all patients was grade Ⅰ. Conclusion Transthoracic mini-invasive surgical occlusion of atrial and ventricular septal defects is safe and effective. The short and middle-term effect is satisfying. It can be widely used in clinical, but multi-center and long-term follow-up and assessment still need to be carried out.

Citation： MENG Xiongwei, YANG Siyuan, HU Xuanyi, JIANG Tian. Efficacy of minimally invasive transthoracic closure of atrial and ventricular septal defects. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(8): 715-718. doi: 10.7507/1007-4848.201708049 Copy

1.	中国医师协会心血管外科医师分会. 经胸微创室间隔缺损封堵术中国专家共识. 中华胸心血管外科杂志, 2011, 27(9): 516-518.
2.	Masura J, Gavora P, Formanek A, et al. Transcatheter closure of secundum atrial septal defects using the new self-centering amplatzer septal occluder: initial human experience. Cathet Cardiovasc Diagn, 1997, 42(4): 388-393.
3.	万连壮, 应朝晖, 姜万维, 等. 食道超声引导下小切口室间隔缺损封堵术的疗效分析. 中国微创外科杂志, 2010, 10(11): 1024-1025.
4.	Carminati M, Butera G, Chessa M, et al. Transcatheter closure of congenital ventricular septal defects: results of the European Registry. Eur Heart J, 2007, 28(19): 2361-2368.
5.	朱达, 赁可, 冯沅, 等. 杂交技术治疗婴幼儿及儿童肌部室间隔缺损——华西医院经验. 中国胸心血管外科临床杂志, 2015, 20(2): 118-122.
6.	邢泉生. 经胸微创封堵室间隔缺损远期结果——附615例6年随访. 中国循环杂志, 2013, 28(s1): 198-199.
7.	Liang T, XiangJun Z, XiaoJing M, et al. New minimally invasive technique to occlude secundum atrial septal defect in 53 patients. Ann Thorac Surg, 2006, 81(4): 1417-1419.
8.	Lin K, Zhu D, Tao K, et al. Hybrid perventricular device closure of doubly committed subarterial ventricular septal defects: mid-term results. Catheter Cardiovasc Interv, 2013, 82(3): E225-E232.
9.	Matyal R, Wang A, Mahmood F. Percutaneous ventricular septal defect closure with amplatzer devices resulting in severe tricuspid regurgitation. Catheter Cardiovasc Interv, 2013, 82(6): E817-E820.
10.	Holzer RJ, Sallehuddin A, Hijazi ZM. Surgical strategies and novel alternatives for the closure of ventricular septal defects. Expert Rev Cardiovasc Ther, 2016, 14(7): 831-841.
11.	Yang Y, Gao L, Xu X, et al. Echocardiographic assessment and guidance in minimally invasive surgical device closure of perimembranous ventricular septal defects. Heart Surg Forum, 2014, 17(4): E206-E211.
12.	Lee WC, Fang CY, Huang CF, et al. Predictors of atrial septal defect occluder dislodgement. Int Heart J, 2015, 56(4): 428-431.
13.	Zhou D, Pan W, Guan L, et al. Transcatheter closure of perimembranous and intracristal ventricular septal defects with the SHSMA occluder. Catheter Cardiovasc Interv, 2012, 79(4): 666-674.
14.	Tao K, Lin K, Shi Y, et al. Perventricular device closure of perimembranous ventricular septal defects in 61 young children: early and midterm follow-up results. J Thorac Cardiovasc Surg, 2010, 140(4): 864-870.
15.	Hongxin L, Lijun S, Wang ZJ, et al. Intraoperative device closure of large secundum atrial septal defects; a safe alternative to transcatheter closure. Eur J Cardiothorac Surg, 2008, 33(6): 1055-1060.
16.	Kornmann LM, Reesink KD, Reneman RS, et al. Critical appraisal of targeted ultrasound contrast agents for molecular imaging in large arteries. Ultrasound Med Biol, 2010, 36(2): 181-191.
17.	马兰, 吴卫华, 陆静, 等. 经食管超声心动图在经胸微创室间隔缺损封堵术中的应用. 全国小儿心胸外科学术会议. 2008.
18.	胡原, 黄鹏, 罗金文, 等. 经食管超声心动图监测偏心型封堵器经胸微创室间隔缺损封堵术的应用. 中国医学影像学杂志, 2015, 23(12): 917-921.
19.	Chen Q, Cao H, Zhang GC, et al. Atrioventricular block of intraoperative device closure perimembranous ventricular septal defects; a serious complication. BMC Cardiovasc Disord, 2012, 12: 21.
20.	苏肇伉. 先天性心脏病微创手术的发展趋势. 中国胸心血管外科临床杂志, 2005, 12(4): 229-231.
21.	李伟, 顾伟礼, 励峰, 等. 微创经胸小切口室间隔缺损封堵术的临床应用. 中国胸心血管外科临床杂志, 2016, 23(2): 191-193.

1. 中国医师协会心血管外科医师分会. 经胸微创室间隔缺损封堵术中国专家共识. 中华胸心血管外科杂志, 2011, 27(9): 516-518.
2. Masura J, Gavora P, Formanek A, et al. Transcatheter closure of secundum atrial septal defects using the new self-centering amplatzer septal occluder: initial human experience. Cathet Cardiovasc Diagn, 1997, 42(4): 388-393.
3. 万连壮, 应朝晖, 姜万维, 等. 食道超声引导下小切口室间隔缺损封堵术的疗效分析. 中国微创外科杂志, 2010, 10(11): 1024-1025.
4. Carminati M, Butera G, Chessa M, et al. Transcatheter closure of congenital ventricular septal defects: results of the European Registry. Eur Heart J, 2007, 28(19): 2361-2368.
5. 朱达, 赁可, 冯沅, 等. 杂交技术治疗婴幼儿及儿童肌部室间隔缺损——华西医院经验. 中国胸心血管外科临床杂志, 2015, 20(2): 118-122.
6. 邢泉生. 经胸微创封堵室间隔缺损远期结果——附615例6年随访. 中国循环杂志, 2013, 28(s1): 198-199.
7. Liang T, XiangJun Z, XiaoJing M, et al. New minimally invasive technique to occlude secundum atrial septal defect in 53 patients. Ann Thorac Surg, 2006, 81(4): 1417-1419.
8. Lin K, Zhu D, Tao K, et al. Hybrid perventricular device closure of doubly committed subarterial ventricular septal defects: mid-term results. Catheter Cardiovasc Interv, 2013, 82(3): E225-E232.
9. Matyal R, Wang A, Mahmood F. Percutaneous ventricular septal defect closure with amplatzer devices resulting in severe tricuspid regurgitation. Catheter Cardiovasc Interv, 2013, 82(6): E817-E820.
10. Holzer RJ, Sallehuddin A, Hijazi ZM. Surgical strategies and novel alternatives for the closure of ventricular septal defects. Expert Rev Cardiovasc Ther, 2016, 14(7): 831-841.
11. Yang Y, Gao L, Xu X, et al. Echocardiographic assessment and guidance in minimally invasive surgical device closure of perimembranous ventricular septal defects. Heart Surg Forum, 2014, 17(4): E206-E211.
12. Lee WC, Fang CY, Huang CF, et al. Predictors of atrial septal defect occluder dislodgement. Int Heart J, 2015, 56(4): 428-431.
13. Zhou D, Pan W, Guan L, et al. Transcatheter closure of perimembranous and intracristal ventricular septal defects with the SHSMA occluder. Catheter Cardiovasc Interv, 2012, 79(4): 666-674.
14. Tao K, Lin K, Shi Y, et al. Perventricular device closure of perimembranous ventricular septal defects in 61 young children: early and midterm follow-up results. J Thorac Cardiovasc Surg, 2010, 140(4): 864-870.
15. Hongxin L, Lijun S, Wang ZJ, et al. Intraoperative device closure of large secundum atrial septal defects; a safe alternative to transcatheter closure. Eur J Cardiothorac Surg, 2008, 33(6): 1055-1060.
16. Kornmann LM, Reesink KD, Reneman RS, et al. Critical appraisal of targeted ultrasound contrast agents for molecular imaging in large arteries. Ultrasound Med Biol, 2010, 36(2): 181-191.
17. 马兰, 吴卫华, 陆静, 等. 经食管超声心动图在经胸微创室间隔缺损封堵术中的应用. 全国小儿心胸外科学术会议. 2008.
18. 胡原, 黄鹏, 罗金文, 等. 经食管超声心动图监测偏心型封堵器经胸微创室间隔缺损封堵术的应用. 中国医学影像学杂志, 2015, 23(12): 917-921.
19. Chen Q, Cao H, Zhang GC, et al. Atrioventricular block of intraoperative device closure perimembranous ventricular septal defects; a serious complication. BMC Cardiovasc Disord, 2012, 12: 21.
20. 苏肇伉. 先天性心脏病微创手术的发展趋势. 中国胸心血管外科临床杂志, 2005, 12(4): 229-231.
21. 李伟, 顾伟礼, 励峰, 等. 微创经胸小切口室间隔缺损封堵术的临床应用. 中国胸心血管外科临床杂志, 2016, 23(2): 191-193.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Efficacy of minimally invasive transthoracic closure of atrial and ventricular septal defects

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