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Doubly committed subarterial ventricular septal defect closure through tricuspid approach: a clinical analysis

Part of: Surgery

Published online by Cambridge University Press:  28 January 2021

Guanxi Wang Open the ORCID record for Guanxi Wang [Opens in a new window] ,
Rui Liu ,
Kai Ma ,
Benqing Zhang ,
Kunjing Pang ,
Lei Qi ,
Zhongdong Hua  and
Shoujun Li
Guanxi Wang
Affiliation:
Department of Pediatric Center, Fuwai Hospital, Beijing, People’s Republic of China
Rui Liu
Affiliation:
Department of Pediatric Center, Fuwai Hospital, Beijing, People’s Republic of China
Kai Ma
Affiliation:
Department of Pediatric Center, Fuwai Hospital, Beijing, People’s Republic of China
Benqing Zhang
Affiliation:
Department of Pediatric Center, Fuwai Hospital, Beijing, People’s Republic of China
Kunjing Pang
Affiliation:
Department of Pediatric Center, Fuwai Hospital, Beijing, People’s Republic of China
Lei Qi
Affiliation:
Department of Pediatric Center, Fuwai Hospital, Beijing, People’s Republic of China
Zhongdong Hua*
Affiliation:
Department of Pediatric Center, Fuwai Hospital, Beijing, People’s Republic of China
Shoujun Li
Affiliation:
Department of Pediatric Center, Fuwai Hospital, Beijing, People’s Republic of China
*
Author for correspondence: Dr Z. Hua, MD, PhD, Pediatric Cardiac Surgery Center, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 167 Beilishi Road, Xicheng District, Beijing100037, People’s Republic of China. Tel: +86(10)88 398 855; Fax: +86(10)88 398 855. E-mail: richardhua@Sina.com
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Abstract

Background:

The research was to introduce the experience of doubly committed subarterial ventricular septal defect (DCVSD) repaired through tricuspid approach.

Methods:

From January, 2015 to September, 2019, 86 consecutive DCVSD paediatrics underwent repair via right subaxillary vertical incision (RAVI) through tricuspid approach. Perioperative and follow-up data were collected.

Results:

The age and weight at operation were 28.1 ± 18.5 (range: 7–101) months and 12.2 ± 4.2 (6–26.5) kg. There were two patients combined with discrete subaortic membrane, two patients with patent ductus arteriosus, one patient with atrial septal defect, and two patients with abnormal muscle bundle in right ventricular outflow tract. The mean size of ventricular septal defect was 7.0 ± 2.4 (3–13) mm. The defect was repaired with a piece of Dacron patch in 68 patients or directly with 1–2 pledgetted polypropylene sutures in 18 patients. The cardiopulmonary bypass time and aortic cross-clamp time were 46.2 ± 13.3 (23–101) minutes and 29.2 ± 11.5 (12–84) minutes. After 3.1 ± 2.4 (0–14) hours’ ventilator assist and 23.2 ± 32.1 (0–264) hours’ ICU stay, all patients were discharged safely. At the latest follow-up (27.9 ± 14.6 months), echocardiography showed trivial residual shunt in two patients. There was no malignant arrhythmia occurred and there was no chest deformity or asymmetrical development of the breast was found.

Conclusions:

DCVSD repaired via right subaxillary vertical incision through tricuspid approach was safe and feasible, providing a feasible alternative to median sternotomy, and it can be performed with favourable cosmetic results.

Keywords

Subarterial ventricular septal defectright subaxillary vertical incisiontricuspid valve approach
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 5 , May 2021 , pp. 799 - 803
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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References

Momma, K, Toyama, K, Takao, A, et al. Natural history of subarterial infundibular ventricular septal defect. Am Heart J 1984; 108: 1312–1317.CrossRefGoogle ScholarPubMed
Tohyama, K, Satomi, G, Momma, K. Aortic valve prolapse and aortic regurgitation associated with subpulmonic ventricular septal defect. Am J Cardiol 1997; 79: 1285–1289.CrossRefGoogle ScholarPubMed
Cheung, YF, Chiu, CS, Yung, TC, et al. Impact of preoperative aortic cusp prolapse on long-term outcome after surgical closure of subarterial ventricular septal defect. Ann Thorac Surg 2002; 73: 622–627.CrossRefGoogle ScholarPubMed
Jung, H, Cho, JY, Lee, Y. Progression of aortic regurgitation after subarterial ventricular septal defect repair: optimal timing of the operation. Pediatr Cardiol 2019; 40: 1696–1702.CrossRefGoogle ScholarPubMed
Liu, R, Rui, L, Zhang, B, et al. Through tricuspid closure for doubly committed subarterial ventricular septal defect with right vertical subaxillary mini-incision: a matched-pair analysis. Pediatr Cardiol 2019; 40: 1247–1252.CrossRefGoogle ScholarPubMed
Roos-Hesselink, JW, Meijboom, FJ, Spitaels, SE, et al. Outcome of patients after surgical closure of ventricular septal defect at young age: longitudinal follow-up of 22–34 years. Eur Heart J 2004; 25: 1057–1062.CrossRefGoogle ScholarPubMed
Ridderstolpe, L, Gill, H, Granfeldt, H, et al. Superficial and deep sternal wound complications: incidence, risk factors and mortality. Eur J Cardiothorac Surg 2001; 20: 1168–1175.CrossRefGoogle ScholarPubMed
Seipelt, RG, Popov, A, Danner, B, et al. Minimally invasive partial inferior sternotomy for congenital heart defects in children. J Cardiovasc Surg (Torino) 2010; 51: 929–933.Google ScholarPubMed
An, G, Zhang, H, Zheng, S, et al. Minimally invasive surgical closure for doubly committed subarterial ventricular septal defects through a right subaxillary thoracotomy. Interact Cardiovasc Thorac Surg 2016; 23: 924–928.CrossRefGoogle ScholarPubMed
Li, G, Su, J, Fan, X, et al. Safety and efficacy of ventricular septal defect repair using a cosmetic shorter right lateral thoracotomy on infants weighing less than 5 kg. Heart Lung Circ 2015; 24: 898–904.CrossRefGoogle ScholarPubMed
Yan, L, Zhou, ZC, Li, HP, et al. Right vertical infra-axillary mini-incision for repair of simple congenital heart defects: a matched-pair analysis. Eur J Cardiothorac Surg 2013; 43: 136–141.CrossRefGoogle ScholarPubMed
Ma, ZS, Yang, CY, Dong, MF, et al. Totally thoracoscopic closure of ventricular septal defect without a robotically assisted surgical system: a summary of 119 cases. J Thorac Cardiovasc Surg 2014; 147: 863–867.CrossRefGoogle ScholarPubMed
Xiao, C, Gao, C, Yang, M, et al. Totally robotic atrial septal defect closure: 7-year single-institution experience and follow-up. Interact Cardiovasc Thorac Surg 2014; 19: 933–937.CrossRefGoogle ScholarPubMed
van Rijen, EH, Utens, EM, Roos-Hesselink, JW, et al. Medical predictors for psychopathology in adults with operated congenital heart disease. Eur Heart J 2004; 25: 1605–1613.CrossRefGoogle ScholarPubMed
Brandhagen, DJ, Feldt, RH, Williams, DE. Long-term psychologic implications of congenital heart disease: a 25-year follow-up. Mayo Clin Proc 1991; 66: 474–479.CrossRefGoogle ScholarPubMed
Gantt, LT. Growing up heartsick: the experiences of young women with congenital heart disease. Health Care Women Int 1992; 13: 241–248.CrossRefGoogle ScholarPubMed
Marino, BS, Lipkin, PH, Newburger, JW, et al. Neurodevelopmental outcomes in children with congenital heart disease: evaluation and management: a scientific statement from the American Heart Association. Circulation 2012; 126: 1143–1172.CrossRefGoogle ScholarPubMed
Vida, VL, Leon-Wyss, J, Larrazabal, A, et al. Mediastinitis in pediatric cardiac surgery: treatment and cost-effectiveness in a low-income country. Pediatr Cardiol 2007; 28: 163–166.CrossRefGoogle Scholar
Huang, Y, Yan, X, Lu, L, et al. Transcatheter closure of doubly committed subarterial ventricular septal defects with the Amplatzer ductal occluder: initial experience. Cardiol Young 2019; 29: 570–575.CrossRefGoogle ScholarPubMed
Zhao Yang, C, Hua, C, Yuan Ji, M, et al. Transfemoral and perventricular device occlusions and surgical repair for doubly committed subarterial ventricular septal defects. Ann Thorac Surg 2015; 99: 1664–1670.CrossRefGoogle ScholarPubMed
Hornung, M, Franke, J, Id, D, et al. Interventional closure of atrial septal defects, patent oval foramen and ventricular septal defects. Herz 2015; 40: 765–770.CrossRefGoogle ScholarPubMed
Liu, L, Zhao, TL, Yang, YF, et al. Intraoperative device closure of subaortic ventricular septal defects. J Card Surg 2013; 28: 456–460.CrossRefGoogle ScholarPubMed