The Efficacy And Follow-up Study On Minimally Invasive Transthoracic Closure Of Congential Heart Disease

Objective:To evaluate the clinical efficacy and adverse effect of minimally invasive occlusion via thorax for congenital heart disease in early and intermediate term after operation.Methods Between February2011and March2013, by collecting290cases of minimally invasive transthoracic closure of congential heart disease patient’s intraoperative and postoperative data for this study. Refer to the "2011consensus of experts", and selected patients according with strictly standardized options:VSD closure four cases, ASD and PDA closure one case, VSD and PDA closure one cases. After the successful closure, We gave patients with esophageal echocardiography, ECG, vital signs monitored the treatment effects; discharge line echocardiography (TTE), electrocardiogram (ECG), X-ray examination immediately; After1to3months,3to6months,1year,2years later, the patient review (generally one year after the annual review1or2times) with the line TTE, ECG, chest lateral radiographs check and asked whether there were some associated symptoms and gave careful physical examination.Results290Patients were successfully determine the the closure and the sueeess rate of the procedure was98.0%。 Simultaneously,97.3%associated VSD,97.1%associated ASD and100%associated PDA were closed by minimally invasive occlusion via thorax to surgery. The average diameter of VSD measured by ntraoperative transesophageal echocardiography during procedure was4.8±1.6(2to10) mm, ASD was16.4±7.2(4to34) mm; PDA was7.4±2.5(4to12) mm.181VSD occluder devices were implanted and the mean diameter of VSD device was6.8±2.2(4to12) mm;107ASD occluder devices were implanted and the mean diameter of ASD device was21.0±7.9(6to40) mm;9PDA occluder devices were implanted and the mean diameter of PDA device was9.4±3.3(5～16) mm..1patient underwent surgical repair of ASD after taking occluder out in operation; minimal or trivial residual shunts were visualized on echocardiography in5cases and2disappeared before discharge review, the other two cases were disappeared after1month,3months later, one case of muscular ventricular septal defect trivial residual in2mm diameter last2years without change;1case of ASD trivial residual appeared after one month.1case of peri-membranous ventricular septal defect patients got a CAVB and placed a permanent pacemaker.Conclusion The minimally invasive thoracic surgery transcatheter therapy is a safe and effective surgical treatment, which with high success rate and low complication rate, recent mid-term effective, but its long-term effects needs further long-term observation.