Abstract:
BACKGROUND:Open cardiac surgery has traditionally been the gold standard for repair of ventricular septal defect (VSD). The inherent risks and complications associated with open surgery and the incidence of postoperative residual VSD are significant disadvantages of the open surgical approach. OBJECTIVE:To evaluate the methodology and efficacy of transcatheter closure of postoperative residual VSD in children. METHODS:Patients with postoperative VSD who underwent percutaneous device closure in the period from August 2010 and February 2014 in our center were analyzed retrospectively. Twelve children, including 8 males and 4 females, with mean age of 8.13 ± 5.39 years (range 0.67-17 years) and mean weight of 29.63 ± 20.86 kg (range 5.5-66 kg) were included in the study. RESULTS:Ten cases had residual shunts situated at the margin of the patches while the other two had residual shunts because of multiple muscular VSD. The mean VSD diameter was 3.84 ± 1.86 mm (range 2.3-8.7 mm). On cardiac catheterization, the reported mean pulmonary circulatory blood volume/systemic circulation volume (Qp/Qs) ratio was 1.86 ± 0.91 (range 1.1-4.25) and the mean pulmonary artery pressure was 25.92 ± 12.42 mm Hg (range 7-52 mm Hg). Successful transcatheter closure was obtained in all twelve patients with postsurgery residual VSD. Two cases with residual muscular VSD underwent retrograde catheterization via the femoral artery while one case with residual VSD located at the lower margin of the patch was accessed via the internal jugular vein. The mean procedure time was 81.25 ± 25.86 minutes (range 40-120 minutes). There was no evidence of residual VSD, and no instances of new-onset valvular regurgitation were reported, with the only two exceptions being patients who had multiple muscular VSDs where clinically insignificant residual shunts were detected. CONCLUSION:Our retrospective study highlights the potential safety and therapeutic efficacy of transcatheter approach for closing postoperative residual VSD in children. RECOMMENDATIONS:More robust studies with longer-term follow-up of outcomes are required to firmly establish the safety profile and respective indications for use of various occluder devices for treating different categories of residual VSD.
journal_name
Congenit Heart Disjournal_title
Congenital heart diseaseauthors
Zhou W,Li F,Fu L,Gao W,Guo Y,Liu T,Huang M,Zhang Ydoi
10.1111/chd.12357subject
Has Abstractpub_date
2016-07-01 00:00:00pages
323-31issue
4eissn
1747-079Xissn
1747-0803journal_volume
11pub_type
杂志文章abstract::A 22-year-old female with no medical history presented to the emergency room with 2 weeks of rapidly worsening dyspnea on exertion, orthopnea, and cough. On cardiac auscultation, she was noted to have to-and-fro murmurs and a continuous murmur with signs of right heart failure. Echocardiographic images obtained showed...
journal_title:Congenital heart disease
pub_type: 杂志文章,评审
doi:10.1111/j.1747-0803.2010.00467.x
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVE:Atrial septal defect (ASD) is the second most common congenital heart defect (CHD) and is observed in families as an autosomal dominant trait as well as in nonfamilial CHD. Mutations in the NKX2-5 gene, located on chromosome 5, are associated with ASD, often combined with conduction disturbances, cardiomyopat...
journal_title:Congenital heart disease
pub_type: 杂志文章,评审
doi:10.1111/chd.12317
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journal_title:Congenital heart disease
pub_type: 杂志文章,评审
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journal_title:Congenital heart disease
pub_type: 杂志文章,meta分析,评审
doi:10.1111/chd.12503
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章,多中心研究
doi:10.1111/chd.12581
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journal_title:Congenital heart disease
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doi:10.1111/j.1747-0803.2011.00595.x
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journal_title:Congenital heart disease
pub_type: 杂志文章
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journal_title:Congenital heart disease
pub_type: 杂志文章
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journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12054
更新日期:2013-11-01 00:00:00
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journal_title:Congenital heart disease
pub_type: 杂志文章,多中心研究
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journal_title:Congenital heart disease
pub_type: 杂志文章
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journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2010.00430.x
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journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2011.00513.x
更新日期:2012-01-01 00:00:00
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journal_title:Congenital heart disease
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/chd.12452
更新日期:2017-05-01 00:00:00
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journal_title:Congenital heart disease
pub_type: 杂志文章,评审
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journal_title:Congenital heart disease
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pub_type: 杂志文章,评审
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journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2008.00190.x
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pub_type: 杂志文章,评审
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journal_title:Congenital heart disease
pub_type: 杂志文章,评审
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更新日期:2011-05-01 00:00:00
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journal_title:Congenital heart disease
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journal_title:Congenital heart disease
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journal_title:Congenital heart disease
pub_type: 杂志文章
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journal_title:Congenital heart disease
pub_type: 杂志文章
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