Transthoracic Subarterial Ventricular Septal Defect Occlusion Using a Minimally Invasive Incision

Cao, Hua; Chen, Qiang; Zhang, Gui-Can; Qiu, Zhihuang; Xu, Fan

doi:10.1111/jocs.12754

Cited by 8 publications

(11 citation statements)

References 16 publications

(21 reference statements)

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“…They found that in cases with a VSD size > 5 mm, the effective contact area of the occluder became small and, in cases with a VSD size < 5 mm, there was a relatively small opening in the superior margin. Thus, in cases with a VSD size < 5 mm, the device rarely affects the pulmonary valve and is less likely to be displaced from the original position [16]. The incidence of occluder displacement in patients with VSDs > 5 mm was greater than the incidence of displacement in patients with VSDs < 5 mm.…”

Section: Discussionmentioning

confidence: 91%

“…Further meta-regression showed that a ratio of occluder size (mm)/weight (kg) above 0.4 was a risk factor for postoperative RSs with a Coef of − 0.28 (95% CI: − 0.49--0.66, p = 0.020). Zhang and his colleagues also reported that procedure-induced aortic regurgitation (AR) was associated with device diameter and patient weight (OR = 12.3 95% CI 1.5-99.2) [16]. Thus, the ratio of occluder size (mm)/weight (kg) below may be another patient selection criterion for perventricular device closure of dcsVSDs.…”

Section: Discussionmentioning

confidence: 99%

“…1). A total of 9 articles [9][10][11][12][13][14][15][16][17] were included and further analyzed. Five studies were case series, and the other 4 studies were case-control studies, comparing perventricular device closure with surgical repair or transfemoral device closure.…”

Section: Study Selection and Quality Assessmentmentioning

confidence: 99%

“…However, such an approach is still limited by technical difficulty, caused by the special location of dcsVSDs, which results in longer radiation times and lower success rates. In recent years, perventricular device closure of dcsVSDs has been developed as an alternative to conventional surgical repair in China [9][10][11][12][13][14][15][16][17]. No metaanalysis focusing on perventricular device closure of dcsVSDs has been reported.…”

Section: Introductionmentioning

confidence: 99%

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A meta-analysis of perventricular device closure of doubly committed subarterial ventricular septal defects

Huang

Kim

Huang

et al. 2020

J Cardiothorac Surg

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Background: To investigate the safety and efficacy of perventricular device closure of doubly committed subarterial ventricular septal defects (dcsVSDs). Methods: PubMed and Scopus were searched for studies in English that focused on perventricular device closure of dcsVSDs and were published up to the end of September 2019. We used a random-effects model to obtain pooled estimates of the success and complication rates. Results: A total of 9 publications including 459 patients with dcsVSDs were included. The median follow-up duration ranged from 2 months to 5 years, with the mean age of patients ranging from 6.1 months to 4.5 years. The pooled estimate of the overall success rate of device closure in the 9 studies was 0.89 (95% CI: 0.86-0.93, I 2 = 26.5%, P = 0.208). Further meta-regression analysis indicated no significant correlation between the success rate and the following factors: publication year, sample size, study type, mean age, mean weight, mean VSD size, and ratio of device size/weight. The pooled rate of postoperative aortic regurgitation was 0.045 (95% CI: 0.018-0.071, I 2 = 50.96%, P = 0.000). The pooled rate of follow-up aortic regurgitation (AR) was 0.001 (95% CI, − 0.003-0.004, I 2 = 63.00%, P = 0.009.) The pooled estimated rate of severe intraoperative complications was 0.106 (0.073-0.140, I 2 = 70.7%, P = 0.208). Postoperative and follow-up complications were rare. No occurrence of a complete atrioventricular block was reported up to the last follow-up visit. Conclusions: Perventricular device closure may be an alternative to conventional surgical repair in selected patients with dcsVSDs. The success rate was stable regarding the publication year and sample size, suggesting a relatively short learning curve and the technique's potential for application.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Study Selection and Quality Assessmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A meta-analysis of perventricular device closure of doubly committed subarterial ventricular septal defects

Huang

Kim

Huang

et al. 2020

J Cardiothorac Surg

Self Cite

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“…A total of 108 articles were written in Chinese 5,12,26–29,31,32,36–43,46,70–132,134–159,174,175 , whereas 58 articles were written in English 4,6,11,25,30,33–35,44,45,47–69,133,160–163,165–173,176–186 , and the remaining article was written in Portuguese 164 . All trials were published between 1998 and 2016.…”

Section: Resultsmentioning

confidence: 99%

Effects of transthoracic device closure on ventricular septal defects and reasons for conversion to open-heart surgery: A meta-analysis

Zhou

Liu

Zhao

et al. 2017

Sci Rep

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Transthoracic device closure (TTDC) is thought to be a promising technology for the repair of ventricular septal defects (VSDs). However, there is considerable controversy regarding the efficacy and safety of TTDC. The present study aimed to compare the benefits and safety of TTDC with those of conventional open-heart surgery (COHS) and analyze the associated factors causing complications, conversion to COHS and reoperation. Electronic database searches were conducted in PubMed, EMBASE, Cochrane Library, Clinicaltrials.gov and several Chinese databases. A total of 5 randomized controlled trials (RCTs), 7 cohort studies, 13 case-control studies, 129 case series and 13 case reports were included. Compared to COHS, TTDC exhibited superior efficacy with a significantly lower risk of post-operative arrhythmia; however, no significant differences in other outcomes were identified. Meta-regression analysis showed that perimembranous VSDs (pmVSDs), a smaller VSD, a smaller occluder, and a median or subxiphoid approach lowered the relative risk of several post-operative complications, conversion to COHS and reoperation. The current evidence indicates that TTDC is associated with a lower risk of post-operative arrhythmia and is not associated with an increased risk of complications. PmVSDs, a smaller VSD and occluder, and a median or subxiphoid approach correlate with better outcomes when using TTDC.

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A Retrospective Study in Occluding Sub-arterial Ventricular Septal Defect

Yang,

Xi,

2023

Pediatr Cardiol

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Transthoracic Subarterial Ventricular Septal Defect Occlusion Using a Minimally Invasive Incision

Abstract: Transthoracic subarterial ventricular septal defect occlusion using a minimally invasive incision may be an alternative to open surgical repair in selected patients. doi: 10.1111/jocs.12754 (J Card Surg 2016;31:398-402).

Cited by 8 publications

References 16 publications

A meta-analysis of perventricular device closure of doubly committed subarterial ventricular septal defects

A meta-analysis of perventricular device closure of doubly committed subarterial ventricular septal defects

Effects of transthoracic device closure on ventricular septal defects and reasons for conversion to open-heart surgery: A meta-analysis

A Retrospective Study in Occluding Sub-arterial Ventricular Septal Defect

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