微创经胸封堵术治疗干下型室间隔缺损——外科技巧及围手术期管理

Per-ventricular Device Closure of Doubly Committed Sub-arterial Ventricular Septal Defect——Technical Consideration and Perioperative Management

干下型室间隔缺损位于室间隔漏斗部,紧邻主、肺动脉瓣下,由于其解剖类型特殊,传统的心内直视手术创伤大,而经导管微创封堵治疗也不适宜该类缺损的治疗。经胸微创室间隔封堵是一种全新的治疗室间隔缺损的杂交手术技术,该技术突破了传统治疗局限,能够达到微创的治疗干下型室间隔缺损的治疗的目的,本文以此为基础,全面介绍经胸封堵治疗该类室间隔缺损的外科技巧及围手术期管理经验。

Doubly committed sub-arterial ventricular septal defect （VSD） is a unique type of VSD which is located beneath both the aortic and pulmonary valve. Open-heart repair is traumatic especially for pediatric patient while trans- catheter device closure is also not suitable for this type of VSD. Minimally invasive per-ventricular device closure has been introduced as an alternative method in the treatment of doubly committed VSD with encouraging results. In the review, we will illustrate the surgical technique as well as perioperative management strategy as for this technique in treating doubly committed VSD.