Perventricular closure of ventricular septal defects without cardiopulmonary bypass
Abstract
Aim – to present results of perventricular closure of ventricular septal defects (VSD).
Material and methods. 55 patients with VSD underwent perventricular closure without cardio-
pulmonary bypass (CPB) under the guidance of transesophageal echocardiography (TEE) in pediatric cardiac surgery department between November 2013 and January 2016. Mean age of pa-
tients was 32.5±35.5 month (5–175 month). Mean body weight was 13.2±8.4 kg (4.8–52.5 kg).
Defect’s size measured by intraoperative TEE was from 4 to 14 mm (6.01±1.7 mm). Most of VSDs
were perimembranosus (52) and only 3 – muscule оnes.
Results. Successful closure of VSD was performed in 93.6% patients. There were 3 conversions
due to underestimating of size and localization of the defects. Duration of the procedure was from
25 to 90 min (45.4±15.6 min). Residual intraoperative shunt has been identified in 42% patients,
at the time of discharge – in 27% and at 3 month after operation (43 patients were examined) –
in 18.6%. In most of cases tricuspid regurgitation after operation was the same as before or less.
In 24% cases after operation trivial aortic regurgitation was shown (in 16.3% patients 3 month
after, not progressing). Mean duration of mechanical ventilation was 238.6±160.5 min. Mean
hospital stay was 6.73±2 days. There were no intraoperative rhythm disorders. One patient has
late complete atrioventricular block two month after operation with implanted pacemaker.
Conclusions. Perventricular closure of VSD is a safe and effective method in selected patients
with excellent results. It simplifies VSD closure and has no drawbacks of other technics.
Keywords:congenital heart diseases, ventricular septum defect, transventricular closure
Clin. Experiment. Surg. Petrovsky J. 2017; 5 (4): 6–13.
DOI: 10.24411/2308-1198-2017-00001
Received: 25.08.2017. Accepted: 10.10.2017.
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