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Simultaneous transthoracic intervention for multiple cardiac defects in children.
Guo-Liang Lu1, Ting Sun2, Jie-Zhou Huang1
1Department of Cardiovascular Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Translational Pediatrics
|February 26, 2021
Summary
Simultaneous transthoracic interventions for multiple congenital heart defects (CHD) in children are feasible and safe. This minimally invasive approach offers good short-term outcomes for complex pediatric cardiac cases.
Area of Science:
- Pediatric Cardiology
- Minimally Invasive Cardiac Surgery
- Congenital Heart Disease Interventions
Background:
- Transthoracic intervention for isolated congenital heart disease (CHD) is established.
- Increasing clinical use of transthoracic interventions for CHD.
- Experience with simultaneous transthoracic intervention for multiple cardiac lesions in pediatric patients is presented.
Purpose of the Study:
- To present the experience with simultaneous transthoracic intervention for multiple cardiac lesions in pediatric patients.
- To evaluate the feasibility and short-term outcomes of this approach.
- To determine the optimal surgical incision and operational sequence for safety and minimally invasive nature.
Main Methods:
- 20 pediatric patients with multiple CHD underwent simultaneous transthoracic interventions.
- Procedures guided by transesophageal echocardiography (TEE).
- Standardized procedure sequence: Pulmonary Stenosis (PS) → Ventricular Septal Defect (VSD) → Patent Ductus Arteriosus (PDA) → Atrial Septal Defect (ASD).
Main Results:
- Successful occlusion of all cardiac defects without thoracotomy conversion.
- Operation time ranged from 56-120 minutes (mean 75±13 min).
- No serious complications reported before discharge or during follow-up.
Conclusions:
- Simultaneous transthoracic intervention for multiple cardiac defects in children is feasible.
- The approach demonstrates good short-term outcomes.
- Appropriate incision and sequence enhance minimally invasive and safer interventions.
