A comparative study of minimal lower-sternal incision device closure, minimal right thoracic incision device closure, and midsternal open repair of isolated perimembranous VSD, a retrospective cohort study

Dai, Xiao-Fu; Chen, Qiang; Zhang, Gui-Can

doi:10.1016/j.ijcard.2019.11.128

Cited by 3 publications

(4 citation statements)

References 26 publications

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“…VSD is one of the most common congenital heart diseases, and there are many infants and young children with VSD who need treatment every year [ 1 - 4 ] . For many Chinese patients with restrictive VSD, transthoracic device closure may be an option.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, transthoracic device closure has been widely used to treat VSDs in China. This technique combines the advantages of the two treatments abovementioned, such as a fast recovery, no radiation exposure, and small wounds [ 4 ] , but the following complications still exist: 1. late-onset complete atrioventricular block; 2. occluder dislodgement; 3. new valve damage; and 4. other late-onset complications [ 5 - 7 ] . Therefore, these patients should be followed up closely, and aspirin should be taken orally for approximately three months as an anticoagulant.…”

Section: Introductionmentioning

confidence: 99%

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Application of WeChat Platform in Midterm Clinical Follow-Up of Children Who Underwent Transthoracic Device Closure of VSD

Xie¹,

Liu²,

Lei³

et al. 2022

Braz J Cardiovasc Surg

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Introduction The purpose of this study was to investigate the feasibility and superiority of using the WeChat platform for midterm clinical follow-up of children who underwent transthoracic device closure for ventricular septal defects (VSDs). Methods Ninety children with VSDs who underwent transthoracic device closure were divided into a WeChat follow-up group (WFU group) and an outpatient follow-up group (OFU group). The patients were followed up via WeChat or at an outpatient clinic three months and one year after discharge. The incidences of adverse events, associated complications, costs and time spent, loss to follow-up rate, medication adherence, and overall satisfaction were recorded. Results There was no statistically significant difference in the incidence of adverse events or postoperative complications between the two groups. Also, the loss to follow-up rate was similar between them. Compared with the OFU group, there were significant statistical advantages in the WFU group regarding the total time and cost spent, medication adherence, and satisfaction. Conclusion The use of the WeChat platform in midterm clinical follow-up of children who underwent transthoracic device closure for VSDs has the advantages of reducing financial and time burdens, facilitating high medication adherence, and leading to high satisfaction.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Application of WeChat Platform in Midterm Clinical Follow-Up of Children Who Underwent Transthoracic Device Closure of VSD

Xie¹,

Liu²,

Lei³

et al. 2022

Braz J Cardiovasc Surg

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“…Transthoracic minimally invasive device closure (TMIDC) does not mandate full sternotomy and cardiopulmonary bypass (CPB), without vascular diameter restriction and radiographic exposure, is considered suitable for children with PmVSD ( 5 ). Nevertheless, TMIDC still requires an incision of about 3–5 cm and partial sternotomy, which may cause obvious scars and even chest deformity ( 6 ). We used an ultra-small left intercostal incision to perform transthoracic device closure in children with PmVSD without opening the sternum for better cosmetic results.…”

Section: Introductionmentioning

confidence: 99%

Transthoracic device closure of perimembranous ventricular septal defect via a small left intercostal incision in children

Xie,

Zhang,

et al. 2023

Front. Cardiovasc. Med.

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BackgroundIn children with perimembranous ventricular septal defect, surgical repair requires sternotomy and leaves unsightly scars, which can trigger long-term physical and psychological distress. However, transcatheter device closure is limited by vascular diameter, radiographic exposure, and expensive DSA equipment. We used an ultra-small left intercostal incision for transthoracic device closure to avoid the above problems and investigated its safety and feasibility by comparing it with surgical repair.MethodsThis study enrolled 358 children with perimembranous ventricular septal defect. Among them, 152 patients were treated by surgical closure and 206 by transthoracic device closure via an ultra-small left intercostal incision. Perioperative clinical data and postoperative follow-up results were collected and analyzed retrospectively.ResultsThe success rate was similar (P = 0.265) in the two groups: 203/206 patients in the device group vs. 152/152 patients in the surgical group. The operative time, intensive care unit time, mechanical ventilation time, and postoperative hospital stay were significantly shorter in the device group than in the surgical group. Although the incision length of the device group (1.1 ± 0.2 cm) was significant shorter (P < 0.001) than that of the surgical group (6.7 ± 1.5 cm), there was no difference in hospitalization costs between the two groups (P = 0.099). Except for small residual shunt (16/206 vs. 3/152, P = 0.017), the incidence of complications in the device group was lower or equal to that in the surgical group, and all small residual shunt disappeared during follow-up. There was no thoracic deformity in the device group, compared with 11 cases in the surgery group during follow-up (P < 0.001).ConclusionsTransthoracic device closure via an ultra-small left intercostal incision under transesophageal echocardiography guidance is safe and feasible. With appropriate indications, it can be a suitable alternative to surgical closure for treating perimembranous ventricular septal defect in children.

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“… 5) Such perventricular device closures show similar procedural outcomes compared to conventional surgery. 6) …”

Section: Introductionmentioning

confidence: 99%

Echocardiographic Classification of Perimembranous Ventricular Septal Defect Guides Selection of the Occluder Design for Their Transcatheter Device Closure

Singhi¹,

Sivakumar

2021

J Cardiovasc Imaging

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BACKGROUND Perimembranous ventricular septal defects (VSDs) has proximate relation to the aortic and tricuspid valves as well as the conduction tissues. Transcatheter closure utilizes various off-label device designs. METHODS Perimembranous VSD without aortic margin were classified as group A, with thick aortic margin as group B, with membranous septal aneurysm as group C and defects restricted by tricuspid valve attachments as group D. The proposed ideal design was asymmetric device in group A; duct occluder I (ADOI) and muscular ventricular septal occluder (MVSO) in group B; thin profile duct occluder II (ADOII) in group C and ADOI in group D. Device was 0–2 mm larger than the defect. RESULTS Eighty patients with VSD measuring 6.83 ± 2.87mm underwent successful closure. Device was retrieved before release in one group A and one group C patient due to aortic regurgitation. Asymmetric device was used in 16 group A defects. Among group B defects, ADOI was used in 5, ADOII in 5, MVSO in one and asymmetric device in 3. Group C defects were closed with ADOI in 7, ADOII in 10 and asymmetric device in 3. Three patients with multiple exits had 2 ADOII devices. Group D defects were closed using ADOI in 20 and ADOII in 10 patients. There was no late aortic regurgitation or heart block on a follow-up exceeding 7 years. CONCLUSIONS This echocardiographic classification helps device selection in every single patient. While asymmetric device is uniquely suited for group A defects, different designs are appropriate in the other groups.

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A comparative study of minimal lower-sternal incision device closure, minimal right thoracic incision device closure, and midsternal open repair of isolated perimembranous VSD, a retrospective cohort study

Cited by 3 publications

References 26 publications

Application of WeChat Platform in Midterm Clinical Follow-Up of Children Who Underwent Transthoracic Device Closure of VSD

Application of WeChat Platform in Midterm Clinical Follow-Up of Children Who Underwent Transthoracic Device Closure of VSD

Transthoracic device closure of perimembranous ventricular septal defect via a small left intercostal incision in children

Echocardiographic Classification of Perimembranous Ventricular Septal Defect Guides Selection of the Occluder Design for Their Transcatheter Device Closure

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