Feasibility of Blocking Congenital Ventricular Septal Defect or Congenital Atrial Septal Defect through Right Subaxillary Incision_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 HANGYong-bin , LIGang , WANGShu-wei , YANGQiao-ling , XUYan-bin , LIANGQiang , LIUJie

Department of Surgery, Cardiacvascular 153 Central Hospital of People's Liberation Army, Zhengzhou 450007, P. R. China;

Corresponding?author：

HANGYong-bin, Email: hangyongbin123456@126.com

Keywords：

Ventricular(atrial)septal defect; Minimally invasive transthoracic device closure; Right subaxillary incision; Transesophageal echocardiography

DOI：

10.7507/1007-4848.20160191

Video：

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Objective To evaluate the feasibility and safety of blocking congenital ventricular septal defect or congenital atrial septal defect through the small vertical incision of right subaxillary. Methods We retrospectively analyzed the clinical data of 38 patients underwent the surgery of blocking congenital ventricular septal defect or congenital atrial septal defect in our hospital from January to August 2015. There were 22 males and 16 females with a mean age of 10.3±5.2 months, weight of 8.2±3.5 kg. Results There were 34 patients (89.5%) successfully blocked through the small vertical cut of right subaxillary. The average blood loss of those 34 patients was 19.5±13.4 ml and the mean time of surgery was 58.4±28.5 minutes. Four patients (10.5%) with ventricular septal defect failed to block because of aortic valve prolapse. Those patients underwent direct repair of ventricular septal defect under extracorporeal circulation while general anesthesia. There was no serious adverse event during the surgery. The extubation time was 3.9±1.6 hours, the ICU monitoring time was 1.8±0.8 days and the hospital stay time was 3.2±0.5 days. All patients discharged uneventfully. Conclusion Blocking congenital ventricular septal defect or congenital atrial septal defect through the cut of right subaxillary is a feasible, effective, safe, and minimally invasive method. The effect of early follow-up is well.

Citation： HANGYong-bin, LIGang, WANGShu-wei, YANGQiao-ling, XUYan-bin, LIANGQiang, LIUJie. Feasibility of Blocking Congenital Ventricular Septal Defect or Congenital Atrial Septal Defect through Right Subaxillary Incision. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(8): 796-799. doi: 10.7507/1007-4848.20160191 Copy

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4.	丁尋實.常用超聲介導房間隔缺損封堵方法的優缺點比較.心血管病學進展, 2013, 34(6):823-827.
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11.	Hu S, Yang Y, Wu Q, et al. Results of two different approaches to closure of subaortic ventricular septal defects in children. Eur J Cardiothorac Surg, 2014, 46(4):648-653.
12.	邢泉生, 主編.先天性心臟病經胸微創封堵術.第1版.北京:人民衛生出版社, 2014. 58-95.
13.	朱憲明, 劉志平, 趙龍, 等.經胸小切口房間隔缺損封堵術41例報告.中國微創外科雜志, 2009, 9(2):141-142.
14.	Szkutnik M, Qureshi SA, Kusa J, et al. Use of the amplatzer muscular ventricular septal defect occluder for closure of perimembranous ventricular septal defects. Heart, 2007, 93(3):355-358.
15.	Becker P, Frangini P, Heusser F, et al. New surgical approach to device closure of multiple apical ventricular septal defects. Rev Esp Cardiol, 2004, 57(12):1238-1240.
16.	Crossland DS, Wilkinson JL, Cochrane AD, et al. Initial results of primary device closure of large muscular ventricular septal defects in early infancy using perventricular access. Catheter Cardiovasc Interv, 2008, 72(3):386-391.
17.	Amin Z, Berry JM, Foker JE, et al. Intraoperative closure of muscular ventricular septal defect in a canine model and application of the technique in a baby. J Thorac Cardiovasc Surg, 1998, 115(6):1374-1376.
18.	Michel BI, Ewert P, Koch A, et al. Device closure of ventricular septal defects by hybrid procedures:a multicenter retrospective study. Catheter Cardiovasc Interv, 2011, 77(2):242-251.
19.	Tao K, Lin K, Shi K, et al. Perventricular device closure of perimem-branous ventricular septal defects in 61 young children:early and midterm follow-up results. J Thorac Cardiovasc Surg, 2010, 140(4):864-870.
20.	蘇肇伉.先天性心臟病微創手術的發展趨勢.中國胸心血管外科臨床雜志, 2005, 12(4):229-231.

1. ?徐志偉, 主編.小兒心臟手術學.第2版.北京:人民軍醫出版社, 2006. 337-350.
2. Griffin ML, Sullivan ID, Anderson RH, et al. Doubly committed subarterial ventricular septal defect:new morphological criteria with echocardiographic and angiocardiographic correlation. Br Heart J, 1988, 59(4):474-479.
3. Sim EK, Grignani RT, Wong ML, et al. Outcome of surgical closure of doubly committed subarterial ventricular septal defect. Ann Thorac Surg, 1999, 67(3):736-738.
4. 丁尋實.常用超聲介導房間隔缺損封堵方法的優缺點比較.心血管病學進展, 2013, 34(6):823-827.
5. 郭俊曉, 劉志平, 朱憲明, 等.經胸微創室間隔缺損封堵術38例臨床分析.中國胸心血管外科臨床雜志, 2013, 20(6):728-730.
6. 陳力, 李俊仁, 劉霞, 等.多平面經食道超聲心動圖在經胸小切口室間隔缺損封堵術中的應用.醫學影像學雜志, 2013, 23(2):200-203.
7. Gan CP, An Q, Lin K, et al. Perventricular device closure of ventri-cular septal defects:six months results in 30 young children. Ann Thorac Surg, 2008, 86:142-146.
8. 李紅昕, 張慧, 郭文斌, 等.探條輔助微創室間隔缺損封堵術.中華胸心血管外科雜志, 2011, 27(5):271-272.
9. 張玉展, 李紅昕, 黃犇, 等.經胸微創室間隔缺損封堵術的臨床研究.河北醫藥, 2012, 34(18):2746-2747.
10. Lin K, Zhu D, Tao K, et al. Hybrid perventricular device closure of doubly committed subarterial ventricular septal defects:mid-term results. Catheter Cardiovascular Interv, 2013, 82(3):E225-E232.
11. Hu S, Yang Y, Wu Q, et al. Results of two different approaches to closure of subaortic ventricular septal defects in children. Eur J Cardiothorac Surg, 2014, 46(4):648-653.
12. 邢泉生, 主編.先天性心臟病經胸微創封堵術.第1版.北京:人民衛生出版社, 2014. 58-95.
13. 朱憲明, 劉志平, 趙龍, 等.經胸小切口房間隔缺損封堵術41例報告.中國微創外科雜志, 2009, 9(2):141-142.
14. Szkutnik M, Qureshi SA, Kusa J, et al. Use of the amplatzer muscular ventricular septal defect occluder for closure of perimembranous ventricular septal defects. Heart, 2007, 93(3):355-358.
15. Becker P, Frangini P, Heusser F, et al. New surgical approach to device closure of multiple apical ventricular septal defects. Rev Esp Cardiol, 2004, 57(12):1238-1240.
16. Crossland DS, Wilkinson JL, Cochrane AD, et al. Initial results of primary device closure of large muscular ventricular septal defects in early infancy using perventricular access. Catheter Cardiovasc Interv, 2008, 72(3):386-391.
17. Amin Z, Berry JM, Foker JE, et al. Intraoperative closure of muscular ventricular septal defect in a canine model and application of the technique in a baby. J Thorac Cardiovasc Surg, 1998, 115(6):1374-1376.
18. Michel BI, Ewert P, Koch A, et al. Device closure of ventricular septal defects by hybrid procedures:a multicenter retrospective study. Catheter Cardiovasc Interv, 2011, 77(2):242-251.
19. Tao K, Lin K, Shi K, et al. Perventricular device closure of perimem-branous ventricular septal defects in 61 young children:early and midterm follow-up results. J Thorac Cardiovasc Surg, 2010, 140(4):864-870.
20. 蘇肇伉.先天性心臟病微創手術的發展趨勢.中國胸心血管外科臨床雜志, 2005, 12(4):229-231.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Feasibility of Blocking Congenital Ventricular Septal Defect or Congenital Atrial Septal Defect through Right Subaxillary Incision

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