title: Transthoracic Device Closure of Juxtaarterial Ventricular Septal Defects: Midterm Follow-Up Results.
abstract: BACKGROUND
  In recent years, minimally invasive transthoracic device closure has been introduced as an alternative treatment option for selected patients with juxtaarterial ventricular septal defects. This study evaluated the midterm safety and efficacy of using device closure in selected patients.
  
  
  METHODS
  Between January 2008 and December 2014, 25 patients with juxtaarterial ventricular septal defects who met the inclusion criteria were enrolled in this study. Periventricular closure was attempted using minimally invasive transthoracic device closure without cardiopulmonary bypass under general anesthesia and transesophageal echocardiography guidance. Patients were strictly monitored according to a standard protocol by one specially appointed doctor.
  
  
  RESULTS
  Minimally invasive transthoracic device closure was successfully performed in 23 patients (92%) with a median age of 18 months. Device closure failed in 2 patients (1 with aortic regurgitation and 1 with right ventricular outflow tract stenosis), and they were converted to an open operation. No severe complications (device shift, significant arrhythmia, ventricular outflow tract obstruction, or obvious valve regurgitation) were observed. There was no closure-associated valve regurgitation. No patient had worrisome progression of aortic regurgitation or pulmonary regurgitation.
  
  
  CONCLUSIONS
  In select patients, minimally invasive transthoracic device closure of juxtaarterial ventricular septal defects appears to be safe and effective, with good midterm outcomes.
authors.affiliation: Heart Center, Women and Children's Hospital, Qingdao University, Qingdao, Shandong, China; Cardiothoracic Department, People's Hospital of Rizhao, Rizhao, Shandong, China.
authors.forename: Xueying
authors.initials: X
authors.lastname: Song
authors.affiliation: Heart Center, Women and Children's Hospital, Qingdao University, Qingdao, Shandong, China. Electronic address: xingqs0532@163.com.
authors.forename: Quansheng
authors.initials: Q
authors.lastname: Xing
authors.affiliation: Heart Center, Women and Children's Hospital, Qingdao University, Qingdao, Shandong, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Wu
authors.affiliation: Heart Center, Women and Children's Hospital, Qingdao University, Qingdao, Shandong, China.
authors.forename: Yueyi
authors.initials: Y
authors.lastname: Ren
authors.affiliation: Heart Center, Women and Children's Hospital, Qingdao University, Qingdao, Shandong, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Wan
authors.affiliation: Cardiothoracic Department, People's Hospital of Rizhao, Rizhao, Shandong, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Li
mesh_terms: D000293:Adolescent; D006348:Cardiac Surgical Procedures / Q000295:instrumentation*; D002648:Child; D002675:Child, Preschool; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D006345:Heart Septal Defects, Ventricular / Q000175:diagnosis / Q000601:surgery*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011474:Prosthesis Design; D012189:Retrospective Studies; D055989:Septal Occluder Device; D013997:Time Factors; D016896:Treatment Outcome