title: Midterm results of hybrid perventricular closure of doubly committed subarterial ventricular septal defects in pediatric patients.
abstract: OBJECTIVE
  To evaluate the safety and efficiency of using hybrid perventricular closure in treating pediatric patients with the doubly committed subarterial ventricular septal defects (VSD).
  
  
  METHODS
  Ninety pediatric patients with doubly committed subarterial VSD were enrolled from October 2007 to September 2010 in this retrospective study. Among them, 41 underwent open-heart surgery (surgical group), while 49 underwent perventricular device closure (perventricular group).
  
  
  RESULTS
  There was no difference in age (4.36 ± 3.21 vs. 5.82 ± 4.32 years, p > 0.05) between the two groups. VSD diameter was significantly larger in the surgical group than in the perventricular group (5.03 ± 1.31 vs. 6.03 ± 1.94 mm, p < 0.05). There were no major complications such as death, severe valve insufficiency, significant residual shunt, or lethal arrhythmias in two groups. The perventricular group was associated with a significant reduction of transfusion rate (18.4% vs. 97.6%, p < 0.05) as well as mean intensive care unit (ICU) stay (0.97 ± 0.53 vs. 2.78 ± 3.00 days, p < 0.05) in comparison with the surgical group. No difference was noted for complete closure rate between two groups at discharge (97.6% vs. 85.7%, p > 0.05) as well as during follow-up (97.6% vs. 95.9%, p > 0.05). Perventricular device closure was not associated with an increased risk of procedure-induced aortic insufficiency compared with the open-heart surgical group during follow-up (14.3% vs. 14.6%, p > 0.05).
  
  
  CONCLUSIONS
  Hybrid perventricular closure may be an alternative to open-heart surgery in selected pediatric patients with doubly committed subarterial VSD.
authors.affiliation: Pediatric Heart Center and Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R., China.
authors.forename: Da
authors.initials: D
authors.lastname: Zhu
authors.forename: Ke
authors.initials: K
authors.lastname: Lin
authors.forename: Meng Lin
authors.initials: ML
authors.lastname: Tang
authors.forename: Yuan
authors.initials: Y
authors.lastname: Feng
authors.forename: Qi
authors.initials: Q
authors.lastname: An
mesh_terms: D000293:Adolescent; D001803:Blood Transfusion / Q000706:statistics & numerical data; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D006801:Humans; D007223:Infant; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D018579:Patient Selection; D012189:Retrospective Studies; D012306:Risk; D055989:Septal Occluder Device; D016896:Treatment Outcome