Comparison of Transthoracic Device Closure and Surgical Repair with Right Submammary or Right Infra-axillary Thoracotomy for Perimembranous VSD

Chen, Qiang; Lin, Zewei; Hong, Zhi-Nuan; Cao, Hua; Zhang, Gui-Can; Liu, Yu; Zhang, Qiliang

doi:10.1055/s-0038-1660809

Cited by 8 publications

(11 citation statements)

References 26 publications

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“…All the procedure were successful with little complications. The success rate of TTCVSD with lower sternal incision was the same even compared with surgical repair with right infra-axillary thoracotomy or with right submammary thoracotomy [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the clinical effect between the lower sternal incision and the left parasternal fourth intercostal incision in the transthoracic closure of ventricular septal defect

Shangguan

Liao

2021

J Cardiothorac Surg

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Background To analyze the clinical effect of two different ways of minimally invasive transthoracic closure in children with ventricular septal defect (VSD). Methods From January 2015 to July 2019, 294 children with VSD were enrolled in the Fujian Medical University Union Hospital. Patients were divided into two groups – those who underwent VSD closure through the left sternal fourth intercostal incision (group A: n = 95) and the lower sternal incision (group B: n = 129). Results The operation time, bleeding volume, postoperative mechanical ventilation time, postoperative intensive care unit (ICU) monitoring time, postoperative hospitalization time and complication rate in group A were significantly lower than those in group B (P < 0.05). There was no significant difference between the two groups in the operation success rate, mechanical ventilation time and total hospitalization cost (P > 0.05). Conclusion The transthoracic closure of ventricular septal defect through the left sternal fourth intercostal incision is feasible, safe, cosmetic, and worth popularizing.

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Section: Discussionmentioning

confidence: 99%

Comparison of the clinical effect between the lower sternal incision and the left parasternal fourth intercostal incision in the transthoracic closure of ventricular septal defect

Shangguan

Liao

2021

J Cardiothorac Surg

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“…The transcatheter closure of VSD has had an increasing popularity recently due to the advancement of transcatheter techniques, but especially patients with low body weight and VSD near the aortic valves are usually not suitable for this method (8). Chen et al ( 9) compared percutaneous device occlusion with minimally invasive techniques for VSD closure and reported that the minimally invasive technique was more cost-effective than device occlusion but with similar complication rates.…”

Section: Commentmentioning

confidence: 99%

Toward Routine Minimally Invasive Ventricular Septal Defect Closure Via Right Lateral Minithoracotomy

et al. 2021

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Background: Improving the surgical results and recent advancement of transcatheter techniques for closure of ventricular septal defect (VSD) increased the demand for minimally invasive approaches. In this study, we analyzed the results of the patients who underwent VSD closure with right lateral minithoracotomy (RLMT).Methods: Between September 2014 and February 2021, 24 patients underwent minimally invasive VSD closure with RLMT. The median age of the patients was 16 months (range, 4-84 months). Fifteen patients (62.5%) were female. The median weight of the patients was 9.75 kg (range, 4.6-30 kg). The types of VSD were perimembranous in 19 patients, subaortic in three patients, inlet in one patient, and subpulmonic in one patient. Five patients had low-lying pulmonary stenosis in addition to VSD.Results: No perioperative death or major complication occurred during follow-up. All defects were repaired through RLMT. The median cardiopulmonary bypass time was 81 min (range, 44-163 min), and the aortic cross-clamp time was 65 min (range, 33-131 min). The median hospital stay was 6 days (range, 5-21 days). One patient had minimal (2 mm) residual left-to-right shunt. All families were satisfied with the cosmetic results during the follow-up.Conclusions: The RLMT method is a safe and effective alternative to standard median sternotomy for VSD closure and can be performed with favorable cosmetic and clinical results.

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“… 4) Increasing procedural success using these devices have encouraged cardiac surgeons to employ these devices through minimally invasive incisions without resorting to extracorporeal circulation. 5) Such perventricular device closures show similar procedural outcomes compared to conventional surgery. 6) …”

Section: Introductionmentioning

confidence: 96%

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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Comparison of Transthoracic Device Closure and Surgical Repair with Right Submammary or Right Infra-axillary Thoracotomy for Perimembranous VSD

Abstract: TTDC, SRRIAT, and SRSMT all showed excellent outcomes and cosmetic appearances for selected VSD patients. TTDC had advantages over SRRIAT and SRSMT in terms of short operation duration and smaller incision size and shorter durations of intensive care and hospital stays.

Cited by 8 publications

References 26 publications

Comparison of the clinical effect between the lower sternal incision and the left parasternal fourth intercostal incision in the transthoracic closure of ventricular septal defect

Comparison of the clinical effect between the lower sternal incision and the left parasternal fourth intercostal incision in the transthoracic closure of ventricular septal defect

Toward Routine Minimally Invasive Ventricular Septal Defect Closure Via Right Lateral Minithoracotomy

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

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