Hybrid Therapy To Repair Muscular Ventricular Septal Defect Associated With Additional Congenital Heart Disease

Objective: This paper is to discussclinical effect and clinical valueof using Hybrid therapy to repair muscular ventricular septal defect(mVSD)associated with additionalcongenital heart disease in children.Methods: Retrospective analysis from December 2010 to December 2016 in Tianjin Chest Hospital Cardiac Surgery Department using Hybrid therapy for Treatment of 18 cases of complicated cardiac malformation ventricular septal defect in children with clinical data and follow-up data.18 patients including 9 boys and 9 girls were grouped here,their average agewas 8.12±9.28 months and their average weight was 5.94±2.05 kg.The mainly additional congenital heart diseases are: Tetralogy of Fallot,coarctation of aorta,complete transposition of great arteries,double outlet right ventricle,mitral valve cleft.Corrective surgeries for treating complex malformation and occlusion of mVSD were given to all the patients under direct supervision using the Hybrid therapy.Results:The surgical procedure of this group of patients is smoothly,no death during surgery.The operation time is 255.67±71.60 minutes.The cardiopulmonary bypass timeis 127.17±40.77 minutes.Theaorta blocking time is 74.50±29.90 minutes.After surgery,4 patients died through the operation,1 patient died of infect after surgery,1 patient died of the complex malformation which wasn't repaired,1 patient died of mitral valve damage for occluder device replacement,1 patient died of arrhythmia about which the reason was not found yet.1 patient did non planned re-operation because of the huge membranous ventricular septal defect for the first stage surgery in which no mVSD was found.All the rest patients completed their first stage treatment and discharged from hospital.No followed up death recordis there from 1 month to 5 years' time period.14 cases of occluderdevice are in correctposition,12 cases have showed no residual shunt,2 cases have showed(under the occluder edge residue left to right)shunt slender,approximately 1-2mm.The cardiac function in 13 cases are normal(left ventricularejection fraction:63.23±5.20%)and in 1 case is slightly worse(left ventricularejection fraction:42%).Conclusions:Using Hybrid therapy to repair mVSD associated with additional congenital heart disease in children,can avoid the adverse effects of traditional surgical methods on ventricular function due to the need of ventricular incision,still it has no limitation of receptor quality and vascular access,especially suitable for babies with complex cardiac malformations.It can reduce the injury of heart,the operation time,the operation risk and the complications,also can improve the curative effect,the survival rate and shorten the recovery time.