The Effect And Preliminary Follow-Up Outcome Of Interventional Therapy In 151 Children With Congenital Heart Diseases

Objective:To assess the safety and effectiveness of interventional therapy in children with congenital heart disease(CHD) by reviewing and analysising the clinical effect, main complications and follow-up outcome.Methods:151 children with CHD received interventional therapy were retrospectively analysised.They were admitted to Department of Pediatrics, First Affiliated Hospital Of Guangxi Medical University from December 2004 to December 2010. We measured the children's age,gender,body weight, the length of hospital stay,the result of transthoracic echocardiography,X-ray and electrocardiography and analysised their clinical and follow-up data.Results:(2)The data of 151 cases,including 77 males and 74 females, age from 4 months to 14 years, body weight (17.0±8.7) kg;44 cases≤3 years and 72 cases with pulmonary arterial hypertension(PAH). (2) 41 cases with ventricular septal defect(VSD),29 cases with atrial septal defect (ASD),63 cases with patent ductus arteriosus(PDA),12 cases with pulmonary stenosis(PS),5 cases with ASD+PS and 1 cases with VSD+PDA. They underwent the transcatheter closure or percutaneous balloon pulmonary valvuloplasty. (3)The total success rate of procedure was 98.7%(149/151). VSD group 97.6% (40/41),PDA group 98.4%(62/63).ASD group,PS group and compound CHD group (ASD+PS,VSD+PDA) 100%. (4) The mean time of procedure (94.8±40.2) minutes. The length of hospital stay(11.0±5.4)days. The length of hospital stay after procedure (5.3±2.3)days.The charge (26352.35±5134.36) RMB. The success rate of the procedure in infant,with PAH and heart failure was the same as in children>3years, without PAH and heart failure. (5) The cardiothoracic ratio 0.55±0.06 decreased to 0.54±0.06 (t=6.012, P<0.05) postoperative 48 hours. (6) Compared with preoperative data,in VSD group, the left atrial diameter (LAD),left ventricular end-diastolic diameter(LVEDD) decreased (P<0.05)postoperative 1 month.stroke volume(SV) increased (P<0.05). In ASD group,right ventrieular diameter(RVD) decreased (P<0.05) postoperative 1 month.LAD,LVEDD,SV increased (P<0.05) postoperative 3 months. In PDA group, LAD postoperative 1 month,LVEDD postoperative 3 months and left ventrieular end-systolic diameter (LVESD) postoperative 6 months decreased (P<0.05), SV decreased (P<0.05) postoperative 1 month. (7)The main complications occurred in 1 week included arrhythmia,residual shunt and hemolysis. The incidence of complications occurred in 1 week:VSD group 11.9%, ASD group 16.1%, PDA group 4.6%, PS group and compound CHD group didn't have complication. (8)132 cases (87.4%)were followed up from 1 month to 5 years after the procedure.1 case dead(0.6%). The incidence of complication:l monthl.9%,3 months 1.3%,6 months 0.7%,1 year 0.8%,2 years 1%,3 years 1.4%,4 years and 5 years didn't have complication.Conclusion:(1)Percutaneous transcatheter therapy on CHD in children was safe,satisfactory and effective.The incidence rate of complication was low.The short-term and mid-term followed-up result was satisfactory. (2)Children with indications of CHD interventional therapy were supposed to choose these therapy first. (3)The cordis structure and function obviously improved after procedure. (4) Postoperative follow-up was supposed to be strictly administered in a long time to monitor the incidence of complications.