title: Perventricular device closure of ventricular septal defects: results in patients less than 1 year of age.
abstract: OBJECTIVE
  To present and share our experience in perventricular device closure of ventricular septal defects in patients less than 1 year old.
  
  
  METHODS
  From 2012-2014, 51 patients less than 1 year old with ventricular septal defects were operated on with minimally invasive transthoracic device closure under the guidance of transoesophageal echocardiography (TOE) without cardiopulmonary bypass (CBP). The median age at operation was 8.0 ± 2.5 months and the mean body weight was 7.9 ± 3.4 kg; 7.3% (5) of patients had a weight less than 5 kg. The Qp/Qs ratio was 1.9 ± 0.4. The ventricular septal defect size ranged from 3 to 9 mm; the mean diameter was 5.7 ± 1.6 mm; 27.4% (14) of defects were subaortic, 66.7% (34) perimembranous and 5.9% (3) were muscular. For defect closure, we used a ventricular septal defect occlusion device (Lepu Medical Technology Co., Ltd, Beijing, China) through a 3-cm skin incision in the lower third of the sternum.
  
  
  RESULTS
  The procedural success rate was 96.1% and there were 2 patients who were converted to open-heart surgery (3.9%) during procedures. The operation time 'skin to skin' was 55.9 ± 41.0 (40) min; 48.8% of cases were less than 40 min. Intensive care unit stay was 16.5 ± 9.4 (18) h; ventilation time was 3.2 ± 3.5 (2) h; all patients did not require inotropic support, blood transfusion and analgesia. Of the total, 7.8% (4) of patients had residual shunt of not more than 1 mm; there were no atrioventricular blocks, rhythm disturbances or other types of major complications in the early postoperative period. Length of hospital stay was 5.6 ± 3.2 days. The mean follow-up was 18.7 ± 10.1. Residual shunts, conduction disturbances or valve complications were not observed in any patients.
  
  
  CONCLUSIONS
  Perventricular device closure of ventricular septal defects showed safety and high efficiency in patients less than 1 year of age, compared with conventional surgical repair with cardiopulmonary bypass, and provided a short period of rehabilitation and excellent cosmetic result.
authors.affiliation: Division of Congenital Heart Surgery, State Research Institute of Circulation Pathology, Novosibirsk, Russian Federation.
authors.forename: Alexander
authors.initials: A
authors.lastname: Omelchenko
authors.affiliation: Division of Congenital Heart Surgery, State Research Institute of Circulation Pathology, Novosibirsk, Russian Federation.
authors.forename: Yuriy
authors.initials: Y
authors.lastname: Gorbatykh
authors.affiliation: Division of Congenital Heart Surgery, State Research Institute of Circulation Pathology, Novosibirsk, Russian Federation alex99.88@mail.ru.
authors.forename: Alexey
authors.initials: A
authors.lastname: Voitov
authors.affiliation: Division of Congenital Heart Surgery, State Research Institute of Circulation Pathology, Novosibirsk, Russian Federation.
authors.forename: Gregory
authors.initials: G
authors.lastname: Zaitsev
authors.affiliation: Division of Congenital Heart Surgery, State Research Institute of Circulation Pathology, Novosibirsk, Russian Federation.
authors.forename: Alexander
authors.initials: A
authors.lastname: Bogachev-Prokophiev
authors.affiliation: Division of Congenital Heart Surgery, State Research Institute of Circulation Pathology, Novosibirsk, Russian Federation.
authors.forename: Alexander
authors.initials: A
authors.lastname: Karaskov
mesh_terms: D006348:Cardiac Surgical Procedures / Q000295:instrumentation*; D017548:Echocardiography, Transesophageal; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D061646:Operative Time; D011184:Postoperative Period; D019736:Prostheses and Implants; D011474:Prosthesis Design
keywords: Infants; Perventricular; Ventricular septal defect