Transthoracic Subarterial Ventricular Septal Defect Occlusion Using a Minimally Invasive Incision
Hua Cao1, Qiang Chen1, Gui-Can Zhang1
1Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, P.R. China.
Insights
Minimally invasive transthoracic occlusion of subarterial ventricular septal defects is feasible. This approach offers a potential alternative to open surgery for selected patients, with good long-term outcomes.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Procedures
- Congenital Heart Defects
Background:
- Subarterial ventricular septal defects (VSDs) pose surgical challenges.
- Traditional open repair carries significant risks.
- Investigating less invasive occlusion methods is crucial.
Purpose of the Study:
- To assess the feasibility of transthoracic occlusion of subarterial VSDs.
- To evaluate the safety and efficacy of a minimally invasive approach.
- To compare outcomes with traditional open surgical repair.
Main Methods:
- Eighty-one patients underwent transthoracic subarterial VSD occlusion from 2009-2014.
- A minimally invasive incision and a specialized delivery sheath were utilized.
- Eccentric occluders were implanted to close the defects.
Main Results:
- Successful closure was achieved in 74 cases (91.4%).
- Perioperative complications included arrhythmia (5 cases) and pericardial effusion (2 cases).
- No late occluder dislocation, leakage, or thrombus-related issues were observed during 1-5 years of follow-up.
Conclusions:
- Transthoracic subarterial VSD occlusion via a minimally invasive incision is a viable option.
- This technique may serve as an alternative to open surgical repair in select patients.
- The procedure demonstrates favorable short- and long-term results.
Background:
This study sought to investigate the feasibility of transthoracic occlusion of a subarterial ventricular septal defect using a minimally invasive incision.
Methods:
Between January 2009 and June 2014, we performed transthoracic subarterial ventricular septal defect occlusion for 81 patients via a minimally invasive incision. A special delivery sheath was used during surgery, and an eccentric occluder was implanted in the ventricular septal defect.
Results:
Successful defect closure was achieved in 74 cases, perioperative arrhythmia occurred in five cases, and a large pericardial effusion was observed in two cases. Open heart surgery was performed for two patients to repair postoperative dislocation of the occluder. Intraoperative conversion to surgical repair was required in seven cases. During one to five years of follow-up, there was no late occluder dislocation, residual leakage, or thrombus-related complications.
Conclusions:
Transthoracic subarterial ventricular septal defect occlusion using a minimally invasive incision may be an alternative to open surgical repair in selected patients. doi: 10.1111/jocs.12754 (J Card Surg 2016;31:398-402).
