Clinical results of ultrasound-guided thoracoscopic atrial septal defect closure_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

GONG Dingxu , ZHENG Zhe , ZHAO Guangzhi , XIE Yongquan , ZHANG Fengwen ,  PAN Xiangbin

Department of Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, P.R.China;

Corresponding?author：

PAN Xiangbin, Email: xiangbin428@hotmail.com

Keywords：

Atrial septal defect; thoracoscopy; ultrasound-guided intervention; transcatheter closure

DOI：

10.7507/1007-4848.201801011

Video：

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Objective To analyze the safety and effectiveness of ultrasound-guided thoracoscopic atrial septal defect (ASD) closure. Methods We prospectively collected the clinical data of 12 patients with ASD treated by ultrasound-guided thoracoscopic ASD closure in Fuwai Hospital from January to September 2017. The characteristics of the patients' ASD and operation, operation safety and effectiveness, postoperative complications and follow-up results were analyzed. Results Among the 12 patients, 10 were successfully treated with ultrasound-guided thoracoscopic ASD closure. Two patients switched to ASD repair under thoracoscopy-assisted cardiopulmonary bypass. The size of the ASD was 17-40 (27.22±8.97) mm and the size of the occluder was 36 (30-42) mm. The average postoperative length of hospital stay was 6 days. There were no complications such as arrhythmia, bleeding and pericardial effusion after operation. The average follow-up was 6 (3-10) months after the operation. During the follow-up, no Ⅲ-degree conduction block, occluder dislocation, residual shunt or cardiac pericardial effusion was found. Conclusion Ultrasound-guided thoracoscopic ASD closure is a minimally invasive, safe and effective treatment. This technique provides a new minimally invasive surgical option for patients with large defect diameter and poor edge condition.

Citation： GONG Dingxu, ZHENG Zhe, ZHAO Guangzhi, XIE Yongquan, ZHANG Fengwen, PAN Xiangbin. Clinical results of ultrasound-guided thoracoscopic atrial septal defect closure. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(6): 462-465. doi: 10.7507/1007-4848.201801011 Copy

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2.	O’Byrne ML, Kennedy KF, Rome JJ, et al. Variation in practice patterns in device closure of atrial septal defects and patent ductus arteriosus: An analysis of data from the IMproving Pediatric and Adult Congenital Treatment (IMPACT) registry. Am Heart J, 2018, 196: 119-130.
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4.	周連生, 段大為, 韓世發, 等.電視胸腔鏡輔助下房間隔缺損修補術36例報告. 局解手術學雜志, 2008, 17(5): 318-319.
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6.	Mulukutla V, Qureshi AM, Pignatelli R, et al. Predictive factors for patients undergoing ASD device occlusion who " crossover” to surgery. Pediatr Cardiol, 2018, 39(3): 445-449.
7.	O’Byrne ML, Shinohara RT, Grant EK, et al. Increasing propensity to pursue operative closure of atrial septal defects following changes in the instructions for use of the Amplatzer Septal Occluder device: An observational study using data from the Pediatric Health Information Systems database. Am Heart J, 2017, 192: 85-97.
8.	Kim HR, Jung SH, Park JJ, et al. Risk analysis of the long-term outcomes of the surgical closure of secundum atrial septal defects. Korean J Thorac Cardiovasc Surg, 2017, 50(2): 78-85.
9.	戴汝平, 劉延玲, 張戈軍, 等. 應用Amplatzer封堵器介入治療房間隔缺損療效評價(附60例報告). 中華心血管病雜志, 2000, 28(2): 87-91.
10.	Yoo BW, Kim JO, Eun LY, et al. Time course of the changes in right and left ventricle function and associated factors after transcatheter closure of atrial septal defects. Congenit Heart Dis, 2018, 13(1): 131-139.
11.	李守軍. 先天性心臟病的單純超聲引導下經皮介入治療現狀與展望. 中國循環雜志, 2015, 30(11): 1033-1034.
12.	楊秋藍, 張燕搏, 潘湘斌, 等. 經胸微創封堵術治療先天性心臟病臨床分析. 中華實用診斷與治療雜志, 2016, 30(4): 363-365.
13.	Chen Q, Cao H, Zhang GC, et al. Midterm follow-up of transthoracic device closure of an atrial septal defect using the very large domestic occluder (44-48 mm), a single Chinese cardiac center experience. J Cardiothorac Surg, 2017, 12(1): 74.
14.	Chiu KM, Chen RJ. Videoscope-assisted cardiac surgery. J Thorac Dis, 2014, 6(1): 22-30.
15.	陳海生, 程云閣, 鐘煥清, 等. 胸腔鏡與開胸手術治療先天性心臟病的療效比較. 中國微創外科雜志, 2005, 5(8): 634-635.
16.	潘湘斌. 超聲引導經皮介入治療結構性心臟病的探索和發展前景. 中國胸心血管外科臨床雜志, 2018, 25(5): 359-361.

1. Geva T, Martins JD, Wald RM. Atrial septal defects. Lancet, 2014, 383(9932): 1921-1932.
2. O’Byrne ML, Kennedy KF, Rome JJ, et al. Variation in practice patterns in device closure of atrial septal defects and patent ductus arteriosus: An analysis of data from the IMproving Pediatric and Adult Congenital Treatment (IMPACT) registry. Am Heart J, 2018, 196: 119-130.
3. 潘湘斌, 張鳳文, 逄坤靜, 等. 單純超聲心動圖引導下房間隔缺損介入封堵術的臨床研究. 中國循環雜志, 2014, 29(z1): 76.
4. 周連生, 段大為, 韓世發, 等.電視胸腔鏡輔助下房間隔缺損修補術36例報告. 局解手術學雜志, 2008, 17(5): 318-319.
5. 祁長敏, 高虹. 房間隔缺損三種治療方法的比較研究. 四川醫學, 2009, 30(6): 844-846.
6. Mulukutla V, Qureshi AM, Pignatelli R, et al. Predictive factors for patients undergoing ASD device occlusion who " crossover” to surgery. Pediatr Cardiol, 2018, 39(3): 445-449.
7. O’Byrne ML, Shinohara RT, Grant EK, et al. Increasing propensity to pursue operative closure of atrial septal defects following changes in the instructions for use of the Amplatzer Septal Occluder device: An observational study using data from the Pediatric Health Information Systems database. Am Heart J, 2017, 192: 85-97.
8. Kim HR, Jung SH, Park JJ, et al. Risk analysis of the long-term outcomes of the surgical closure of secundum atrial septal defects. Korean J Thorac Cardiovasc Surg, 2017, 50(2): 78-85.
9. 戴汝平, 劉延玲, 張戈軍, 等. 應用Amplatzer封堵器介入治療房間隔缺損療效評價(附60例報告). 中華心血管病雜志, 2000, 28(2): 87-91.
10. Yoo BW, Kim JO, Eun LY, et al. Time course of the changes in right and left ventricle function and associated factors after transcatheter closure of atrial septal defects. Congenit Heart Dis, 2018, 13(1): 131-139.
11. 李守軍. 先天性心臟病的單純超聲引導下經皮介入治療現狀與展望. 中國循環雜志, 2015, 30(11): 1033-1034.
12. 楊秋藍, 張燕搏, 潘湘斌, 等. 經胸微創封堵術治療先天性心臟病臨床分析. 中華實用診斷與治療雜志, 2016, 30(4): 363-365.
13. Chen Q, Cao H, Zhang GC, et al. Midterm follow-up of transthoracic device closure of an atrial septal defect using the very large domestic occluder (44-48 mm), a single Chinese cardiac center experience. J Cardiothorac Surg, 2017, 12(1): 74.
14. Chiu KM, Chen RJ. Videoscope-assisted cardiac surgery. J Thorac Dis, 2014, 6(1): 22-30.
15. 陳海生, 程云閣, 鐘煥清, 等. 胸腔鏡與開胸手術治療先天性心臟病的療效比較. 中國微創外科雜志, 2005, 5(8): 634-635.
16. 潘湘斌. 超聲引導經皮介入治療結構性心臟病的探索和發展前景. 中國胸心血管外科臨床雜志, 2018, 25(5): 359-361.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical results of ultrasound-guided thoracoscopic atrial septal defect closure

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