Transthoracic echocardiographic guidance of minimally invasive perventricular device closure of perimembranous ventricular septal defect without cardiopulmonary bypass: initial experience.
BACKGROUND
Our purpose was to investigate the feasibility of transthoracic echocardiographic (TTE) guidance for minimally invasive periventricular device closure of perimembranous ventricular septal defects (VSDs).


METHODS
From June 2011 to September 2011, we enrolled 18 young children with perimembranous VSDs to receive minimally invasive device closure in our hospital. All of the patients were examined by TTE to determine the VSD morphology, diameter, and rims. During intra-operative device closure, real-time bedside TTE alone was used to guide device implantation.


RESULTS
Device implantation using TTE guidance was successful in 16 patients. Symmetric devices were used in 14 patients, and asymmetric devices were used in 2 patients. Only one patient experienced mild aortic regurgitation, and there were no instances of residual shunt, significant arrhythmias, thromboembolism, or device displacement. Two patients were transferred to surgical closure, one due to residual shunting and the other as a result of unsuccessful wire penetration of the VSD gap.


CONCLUSIONS
Our data indicate that TTE-guided VSD closure is feasible in young children, although a longer follow-up may be needed to document the long-term success.
Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou 350001, PR China. guicanzhang@yahoo.com
Gui-Can
GC
Zhang
Qiang
Q
Chen
Liang-Wan
LW
Chen
Hua
H
Cao
Li-Ping
LP
Yang
Xi-Jie
XJ
Wu
Xiao-Fu
XF
Dai
Dao-Zhong
DZ
Chen
D006348:Cardiac Surgical Procedures / Q000295:instrumentation*; D002675:Child, Preschool; D004452:Echocardiography / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D018579:Patient Selection; D018084:Ultrasonography, Interventional