Minimally invasive experiences on perventricular device closure of ventricular septal defects in children

Objective To introduce the minimally invasive experiences on perventricular device closure of ventricular septal defects (VSDs) under transesophageal echocardiography (TEE) guidance in two children hospital heart centers.Methods 142 cases of VSDs undertook perventricular device closure under TEE guidance in two centers between July 2007 and July 2011,in which perimembranous VSDs was found in 95 cases,intracristal VSDs in 37 cases and muscular VSDs in 10 cases.Their clinical data was retrospectively analyzed.The diameter of the VSD ranged from 3.0 to 8.5 mm (mean4.7 mm) by TTE,and ranged from 2.5 to 8.0 mm (mean 4.3 mm) by TEE.Results The procedures was completed successfully in 140 cases (97.2％).1 patient (0.7％) was complicated with Ⅲ atrialventricular conduction block in post-operation 5th day.VSD was closed with CPB in the secondary operation,the patient gradually reached to sinus rhythm in post-operation.The device in 1 patient (0.7％) fell off and located in the left pulmonary artery after the operatior.The device was taken out and followed by VSD closure with CPB in the secondary operation.Concentric devices were used in 93cases and eccentric devices were used in 47 cases.During fellow-up,no clinically significant complications were found.Conclusions The minimally invasive penventricular device closuer of VSD without CPB is a safe and effective therapy in children.It should be encouraged in clinical practice. Key words: Heart septal defect,ventricular; Surgical procedures, minimally invasive; Extracorporeal circulation