Original articleAdult cardiacTransthoracic Device Closure of Juxtaarterial Ventricular Septal Defects: Midterm Follow-Up Results
Section snippets
Patients and Methods
Informed consent was obtained from the parents. The study was approved by the Institutional Review Ethics Board of Women and Children’s Hospital, Qingdao University.
Between January 2008 and October 2014, 25 patients with juxtaarterial VSDs underwent minimally invasive transthoracic device closure without cardiopulmonary bypass at the Heart Center of Women and Children’s Hospital of Qingdao. The inclusion criterion was confirmed diagnosis of a juxtaarterial VSD by echocardiography. The exclusion
Results
Patients were a median age of 18 months (range, 3 months to 15 years) at the time of the operation; 13 (52%) were male and 12 (48%) were female. Complete demographic data are reported in Table 1. The procedure was successfully performed in 23 patients (92%). There were no deaths or major morbidity such as obvious residual shunt (>3 mm measured by TEE), more than mild degree AR, device embolism, or fatal arrhythmia during the hospital or follow-up phase. Transventricular VSD closure failed in 2
Comment
Juxtaarterial VSD is a type of VSD that is more common in Eastern races; the defective superior borders are the aortic ring and pulmonary ring. As a result of the special anatomic site, juxtaarterial VSD is an absolute contraindication for transcatheter interventional occlusion, and classic treatment involves repair of the VSD under CPB [4]. Because of a low tendency for spontaneous closure and likelihood of progressive AP as well as insufficiency, such patients should undergo surgical repair
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Ventricular septal defects
Cited by (7)
Intraoperative Device Closure of a Perimembranous Ventricular Septal Defect Using the Right Thoracic Ventricle Approach
2019, Annals of Thoracic SurgeryCitation Excerpt :If closure fails, only a median sternal incision can be applied for VSD repair under CPB, which can cause considerable trauma and cosmetic concerns. At some centers, a right thoracic minimal incision (ie, the right atrial tricuspid approach or the right subaxillary minimal incision to right atrial tricuspid) approach is used for device closure of a VSD [14–16]. These two procedures have advantages, including a good cosmetic appearance of the incision and no need for sternotomy.
Transthoracic device closure of perimembranous ventricular septal defect via a small left intercostal incision in children
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