Ventricular Septal Defects Closure Using a Minimal Right Vertical Infraaxillary Thoracotomy: Seven-Year Experience in 274 Patients

Wang, Qiang; Li, Qingguo; Zhang, Jie; Wu, Zhong; Zhou, Qing; Wang, Dongjin

doi:10.1016/j.athoracsur.2009.11.026

Cited by 48 publications

(52 citation statements)

References 17 publications

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“…A flexible guidewire was advanced through the channel of the probe into the left ventricle. The subsequent steps were as previously reported [3, 4, 6]. When TEE evaluation showed there were no significant residual shunt and no significant aortic or tricuspid valve regurgitation, the second device, connected with a device stay suture beforehand, was released.…”

Section: Methodsmentioning

confidence: 91%

“…Complete atrioventricular blockSeveral studies have reported that the incidence of complete atrioventricular block is approximately 1% to 6.5% in the percutaneous approach [11, 12], and 0 to 3.3% in the perventricular approach [3, 4, 8, 9]. A complete atrioventricular block occurring immediately during the procedure may result directly from mechanical injury or compression caused by catheter or devices.…”

Section: Discussionmentioning

confidence: 99%

“…The delivery sheath loaded with the device was inserted into the right ventricle and advanced through the largest hole of the PmVSD into the left ventricle. Then the device was deployed following the previous reports [3, 4, 6]. …”

Section: Methodsmentioning

confidence: 99%

“…In recent years, perventricular single device closure of PmVSDs has been developed and applied clinically with good results [1–4]. However, no reports have been published on device closure of a wide-spaced multi-hole PmVSD with two devices.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Perventricular double-device closure of wide-spaced multi-hole perimembranous ventricular septal defect

Liang

Zhang

et al. 2017

J Cardiothorac Surg

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BackgroundDevice closure of a wide-spaced multi-hole PmVSD is difficult to succeed in percutaneous approach. This study is to evaluate the feasibility, safety and efficacy of perventricular device closure of wide-spaced multi-hole PmVSD using a double-device implanting technique.MethodsSixteen patients with wide-spaced multi-hole PmVSD underwent perventricular closure with two devices through an inferior median sternotomy approach under transesophageal echocardiographic guidance. The largest hole and its adjacent small holes were occluded with an optimal-sized device. The far-away residual hole was occluded with the other device using a probe-assisted delivery system. All patients were followed up for a period of 1 to 4 years to determine the residual shunt, atrioventricular block and the adjacent valvular function.ResultsThe number of the holes of the PmVSD was 2 to 4. The maximum distance between the holes was 5.0 to 10.0 mm (median, 6.4 mm). The diameter of the largest hole was 2.5 to 7.0 mm (median, 3.6 mm). The success rate of double-device closure was 100%. Immediate residual shunts were found in 6 patients (38%), and incomplete right bundle branch block at discharge occurred in 3 cases (19%). Both complications decreased to 6% at 1-year follow-up. Neither of them had a severe device-related complication.ConclusionsPerventricular closure of a wide-spaced multi-hole PmVSD using a double-device implanting technique is feasible, safe, and efficacious. In multi-hole PmVSDs with the distance between the holes of more than 5 mm, double-device implantation may achieve a complete occlusion.

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Section: Methodsmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Perventricular double-device closure of wide-spaced multi-hole perimembranous ventricular septal defect

Liang

Zhang

et al. 2017

J Cardiothorac Surg

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“…De nombreuses études rapportent le développe-ment de techniques dites mini-invasives, permettant d'éviter la classique sternotomie médiane dans la prise en charge de certaines cardiopathies congénitales. Ainsi, des équipes réalisent des abords de type « mini-sternotomie », des abords trans-xyphoïdiens, des thoracotomies antéro-latérales ou postéro-latérales ou encore des abords axillaires horizontaux ou verticaux dont les résultats cosmétiques sont plus acceptables [10][11][12].…”

Section: Les Abords Thoraciquesunclassified

La reprise de cicatrice chez l’enfant : situations cliniques et solutions

Duquennoy-Martinot

Belkhou

Pasquesoone

et al. 2016

Annales de Chirurgie Plastique Esthétique

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Safety Advantage of Modified Minimally Invasive Cardiac Surgery for Pediatric Patients

et al. 2012

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Minimally invasive cardiac surgery (MICS) using a small surgical incision in children provides less physical stress. However, concern about safety due to the small surgical field has been noted. Recently, the authors developed a modified MICS procedure to extend the surgical field. This report assesses the safety and benefit of this modified procedure by comparing three procedures: the modified MICS (group A), conventional MICS (group B), and traditional open heart surgery (group C). A retrospective analysis was performed with 111 pediatric patients (age, 0-9 years; weight, 5-30 kg) who underwent cardiac surgery for simple cardiac anomaly during the period 1996-2010 at Juntendo University Hospital. The modified MICS method to extend the surgical view has been performed since 2004. A skin incision within 5 cm was made below the nipple line, and the surgical field was easily moved by pulling up or down using a suture or a hemostat. The results showed no differences in terms of gender, age, weight, or aortic cross-clamp time among the groups. Analysis of variance (ANOVA) indicated significant differences in mean time before cardiopulmonary bypass (CPB), CPB time, operation time, and bleeding. According to the indices, modified MICS was similar to traditional open surgery and shorter time or lower bleeding volume than conventional MICS. No major mortality or morbidity occurred. In conclusion, the modified MICS procedure, which requires no special techniques, was as safe as conventional open heart surgery and even reduced perioperative morbidity.

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Ventricular Septal Defects Closure Using a Minimal Right Vertical Infraaxillary Thoracotomy: Seven-Year Experience in 274 Patients

Cited by 48 publications

References 17 publications

Perventricular double-device closure of wide-spaced multi-hole perimembranous ventricular septal defect

Perventricular double-device closure of wide-spaced multi-hole perimembranous ventricular septal defect

La reprise de cicatrice chez l’enfant : situations cliniques et solutions

Safety Advantage of Modified Minimally Invasive Cardiac Surgery for Pediatric Patients

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