• Alexander Omelchenko, Yuriy Gorbatykh, Alexey Voitov, Gregory Zaitsev, Alexander Bogachev-Prokophiev, and Alexander Karaskov.
• Division of Congenital Heart Surgery, State Research Institute of Circulation Pathology, Novosibirsk, Russian Federation.
• Interact Cardiovasc Thorac Surg. 2016 Jan 1; 22 (1): 53-6.

ObjectivesTo present and share our experience in perventricular device closure of ventricular septal defects in patients less than 1 year old.MethodsFrom 2012-2014, 51 patients less than 1 year old with ventricular septal defects were operated on with minimally invasive transthoracic device closure under the guidance of transoesophageal echocardiography (TOE) without cardiopulmonary bypass (CBP). The median age at operation was 8.0 ± 2.5 months and the mean body weight was 7.9 ± 3.4 kg; 7.3% (5) of patients had a weight less than 5 kg. The Qp/Qs ratio was 1.9 ± 0.4. The ventricular septal defect size ranged from 3 to 9 mm; the mean diameter was 5.7 ± 1.6 mm; 27.4% (14) of defects were subaortic, 66.7% (34) perimembranous and 5.9% (3) were muscular. For defect closure, we used a ventricular septal defect occlusion device (Lepu Medical Technology Co., Ltd, Beijing, China) through a 3-cm skin incision in the lower third of the sternum.ResultsThe procedural success rate was 96.1% and there were 2 patients who were converted to open-heart surgery (3.9%) during procedures. The operation time 'skin to skin' was 55.9 ± 41.0 (40) min; 48.8% of cases were less than 40 min. Intensive care unit stay was 16.5 ± 9.4 (18) h; ventilation time was 3.2 ± 3.5 (2) h; all patients did not require inotropic support, blood transfusion and analgesia. Of the total, 7.8% (4) of patients had residual shunt of not more than 1 mm; there were no atrioventricular blocks, rhythm disturbances or other types of major complications in the early postoperative period. Length of hospital stay was 5.6 ± 3.2 days. The mean follow-up was 18.7 ± 10.1. Residual shunts, conduction disturbances or valve complications were not observed in any patients.ConclusionsPerventricular device closure of ventricular septal defects showed safety and high efficiency in patients less than 1 year of age, compared with conventional surgical repair with cardiopulmonary bypass, and provided a short period of rehabilitation and excellent cosmetic result.© The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

19 keywords...

hide…