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Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
Minimally invasive perventricular device closure of an isolated perimembranous ventricular septal defect with a newly
Xing Quansheng1, Pan Silin, Zhuang Zhongyun
1Pediatric Cardiovascular Centre, Qingdao Children's Hospital, Qingdao, China.
Objective:
We sought to summarize the preliminary clinical experience of minimally invasive transthoracic device closure of perimembranous ventricular septal defects with a new delivery system without cardiopulmonary bypass.
Methods:
Twenty-one patients aged 11 months to 12 years (median age, 3.6 years) with isolated perimembranous ventricular septal defects underwent minimally invasive device closure with an inferior sternotomy of 3 to 5 cm under transesophageal echocardiographic guidance. A single per-right ventricular U-like suture was established, and a new delivery system was introduced, aided by a 16-gauge trocar, including a guidewire, proper sheath, and loading sheath. The proper size of devices was determined by means of transesophageal echocardiographic analysis, and then the device was released under real-time transesophageal echocardiographic monitoring if no significant aortic regurgitation, abnormal atrioventricular valvular motion, or residual interventricular shunt appeared.
Results:
All of the defects were successfully closed. No residual shunt, noticeable aortic or tricuspid regurgitation, or significant arrhythmias appeared during more than 5 months of follow-up.
Conclusion:
Minimally invasive transthoracic device closure of perimembranous ventricular septal defects with a new delivery system without cardiopulmonary bypass is feasible and safe under transesophageal echocardiographic guidance. However, it is necessary to evaluate the intermediate and long-term results.
