经胸微创室间隔缺损封堵62例疗效分析

Curative effect of minimally invasive transthoracic closure on ventricular septal defect in 62 cases

目的：总结微创经胸室间隔缺损（VSD）封堵的经验，探讨手术的疗效和安全性。方法入选2010年1月~2013年10月简阳市人民医院心血管外科住院的室间隔缺损患者62例，男性28例，女性34例，年龄2~57岁。所有患者在经食道超声心动图的监测下由右心室表面荷包送入封堵器，闭合室间隔缺损。结果封堵成功61例，1例因置入后主动脉瓣返流明显加重，改为体外循环。随访12个月，无封堵器移位、心律失常、残余分流、溶血等并发症。结论经胸微创封堵治疗室间隔缺损安全、可行，创伤小，恢复快。

Objective To sum up the experience of minimally invasive transthoracic closure for treating ventricular septal defect （VSD）, and discuss the curative effect and safety. Methods The patients （n=62, male 28 and female 34, aged from 2 to 57） were chosen from Jan. 2010 to Oct. 2013. All patients were treated with occluder implanted from right ventricular surface pouch under the monitoring of transoesophageal echocardiogram for closing VSD. Results There were 61 cases with successful closure, and the closure was changed over from occluder to cardiopulmonary bypass in 1 case because of exacerbated aortic regurgitation. After follow-up for 12 m, there were no occluder shift, arrhythmia, residual shunt and hemolysis observed. Conclusion The minimally invasive transthoracic closure for treating VSD is safe, feasible with mild wound and faster recovery.