Summary Of Experiences Result Of Transesophageal Ultrasound Guided Ventricular Septal Defect And Atrial Septal Defect Closure Operation

Objective:A retrospective study was conducted to analyze the clinical effect of minimally invasive surgical closure of ventricular septal defects and atrial septal defects guided by transesophageal echocardiography,and the relevant surgical experience was summarized.Methods:Retrospective analysis the first affiliated hospital of nanchang university heart vascular surgery in October 2009 to October 2019,928 cases of the esophageal ultrasound guided transsternal median small incision or transepidermal-femoral vein puncture(the following be called for short percutaneous route)operating ventricular septal defect(Ventricular septal defect,the VSD),atrial septum defect(Atrial septal defect,ASD)surgical minimally invasive closure of patients related clinical data: gender,age,weight,defect type and diameter,etc.The clinical data of the whole group were statistically analyzed,including 552 cases of ventricular septal defect and 376 cases of atrial septal defect.Including 478 male patients and 450 female patients,whose age ranged from 4 months to 74 years(8.64 ± 2.42 years)and weight ranged from 8 to 56(23.32 ± 12.26)kg.Results:1.All the patients in the group received minimally invasive surgical closure,no patient died due to factors related to surgery,finally 907 cases were successful,with a success rate of 97.7%.2.In the whole group,a total of 552 patients with ventricular septal defect were selected to closure the defect through the midline chest small incision,540 patients were successfully closured,and 12 of whom were treated with open heart surgery under cardiopulmonary bypass.3.Among the 376 patients with atrial septal defect,256 patients took the transthoracic median small incision approach,251 patients successfully closured,2 cases failed and 3 cases drop.Another 120 cases adopted transepidermal-femoral vein puncture closure,116 cases succeeded,2 cases failed,and 2 cases fell off.4.During Postoperative follow-up,1 patients with successful closure surgery were found to have complete atrioventricular block,and the other patients were not found to have complications such as aortic valve or tricuspid valve,pericardial effusion,hemolysis event,or thrombosis.5.In the whole group,the operation time was 30~87(51.28 ± 10.35)min,intraoperative blood loss was 15~35(23.64 ± 4.26)ml,postoperative ventilator use time was 2~10(4.76 ± 0.33)h,and the length of hospital stay was 4~10(6.43 ± 1.26)d.Conclusions:1.Transesophageal ultrasound-guided VSD and ASD were closured with less trauma,less blood loss,shorter hospitalization period,simple operation,fewer postoperative complications,and significant therapeutic effect.2.Transesophageal ultrasound-guided minimally invasive surgical closure operation: transsternal median small incision route more short so it can be used more widely;percutaneous route closure is more minimally invasive,and is often used in pediatric ASD closure,in view of it surgical support.3.According to the different ASD defect types and their diameters,the corresponding closure routes can be selected to improve the success rate of operation.4.Through the postoperative review and regular follow-up of 907 patients with successful closure,it is proved that transesophageal echocardiographic guided VSD and ASD closure is safely,effective and feasible.