title: Experience with percardiac interventions for multiple congenital heart diseases in children.
abstract: OBJECTIVE
  To report our experience with percardiac interventions for multiple congenital heart diseases in children.
  
  
  METHODS
  From April 2010 to December 2013, a total of 64 patients (33 males and 31 females), aged 4.38 ± 2.97 years, with multiple congenital heart diseases underwent attempted percardiac interventional procedures. The cohort included 34 ventricular septal defects (VSDs) with atrial septal defect (ASD), 9 VSDs with patent foramen ovale (PFO), 17 VSDs with patent ductus arteriosus (PDA), 2 VSDs with pulmonary stenosis (PS) and 2 VSDs with ASD and PDA. A mini-incision in the inferior sternum was made, and percardiac device closure and balloon valvuloplasty were performed for VSD, ASD, PDA and PS.
  
  
  RESULTS
  Fifty-nine patients (92%) were successfully occluded, and 5 (8%) were converted to open-heart surgery after the failure of occlusion. A total of 111 devices were implanted in the patients (average of 1.88 devices/patient). No severe complications occurred. Incomplete right bundle branch block (IRBBB) occurred in 5 patients (8%) after the operation. Atrioventricular valve regurgitation decreased in 4 patients (6%), but new trivial regurgitation was detected in another patient (2%). A trivial residual shunt without murmur was found in 1 patient (2%), and the residual shunt was closed in the 3-month follow-up. Pericardial effusion occurred in 1 patient (2%).
  
  
  CONCLUSIONS
  Treating the patients who have multiple congenital heart diseases with a percardiac intervention is feasible, and the results should be satisfactory. However, more experience and long-term follow-up are mandatory to assess the safety and effectiveness of these procedures as alternatives to conventional therapy.
authors.affiliation: Department of Cardiothoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Shijun
authors.initials: S
authors.lastname: Hu
authors.affiliation: Department of Cardiothoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Yifeng
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Cardiothoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of Cardiothoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Wu
authors.affiliation: Department of Cardiothoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Rwakaryebe
authors.initials: R
authors.lastname: Muhoozi
authors.affiliation: Department of Cardiothoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Shijie
authors.initials: S
authors.lastname: Wei
authors.affiliation: Department of Cardiothoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Xiaojie
authors.initials: X
authors.lastname: Huang
authors.affiliation: Department of Cardiothoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, China dr.zhaotl@gmail.com.
authors.forename: Tianli
authors.initials: T
authors.lastname: Zhao
mesh_terms: D000015:Abnormalities, Multiple; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: Children; Congenital heart diseases; Percardiac intervention