Simple pulmonary artery approach in subarterial ventricular septal defect repair in 102 patients: A clinical analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANG Yong , TIAN Miao , ZHANG Kai , WEN Shusheng , XU Gang ,  CHEN Jimei

Guangdong Provincial Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, 510100, P.R.China;

Corresponding author：

CHEN Jimei, Email: jimei@hotmail.com

Keywords：

Ventricular septal defect; pulmonary artery; approach; repair; surgery

DOI：

10.7507/1007-4848.201906066

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To summarize and analyze the experience of subarterial ventricular septal defect (VSD) repaired with simple pulmonary artery approach.Methods We retrospectively anlyzed the clinical data of 102 patients with subarterial VSD repaired with simple pulmonary artery approach in our hospital from August 2015 to October 2018. There were 67 males and 35 females at median age of 3 years (ranging 4 months to 49 years).Results The median operation time was 82 (54-136) min. Median cardiopulmonary bypass time was 36 (21-62) min. The median aortic cross-clamping time was 13 (7-32) min. Thirty two patients of tracheal intubation were removed from the fast-track operating room immediately after surgery. Of the 102 patients, 67 patients underwent a small incision in the lower sternum. The median postoperative ICU stay time was 26 (13-36) h. There was no planned reoperations and no early death.Conclusion Simple pulmonary artery approach for subarterial ventricular septal defect repair with less intracardiac procedures, short operation time, less trauma, quick postoperative recovery has certain advantages in the application of specific groups.

Citation： ZHANG Yong, TIAN Miao, ZHANG Kai, WEN Shusheng, XU Gang, CHEN Jimei. Simple pulmonary artery approach in subarterial ventricular septal defect repair in 102 patients: A clinical analysis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(1): 73-76. doi: 10.7507/1007-4848.201906066 Copy

1.	Cao H, Chen Q, Zhang GC, et al. Transthoracic subarterial ventricular septal defect occlusion using a minimally invasive incision. J Card Surg, 2016, 31(6): 398-402.
2.	Waqar T, Rizvi MFA, Baig AR. Doubly committed subarterial ventricular septal defect repair: An experience of 51 cases. Pak J Med Sci, 2017, 33(5): 1112-1116.
3.	Liu R, Rui L, Zhang B, et al. Through tricuspid closure for doubly committed subarterial ventricular septal defect with right vertical subaxillary mini-incision: a matched-pair analysis. Pediatr Cardiol, 2019, 40(6): 1247-1252.
4.	Duong DH, Pham QD. Closure of subarterial ventricular septal defect with minimally invasive surgical technique: A case report. Int J Surg Case Rep, 2019, 58: 142-144.
5.	Lun K, Li H, Leung MP, et al. Analysis of indications for surgical closure of subarterial ventricular septal defect without associated aortic cusp prolapse and aortic regurgitation. Am J Cardiol, 2001, 87(11): 1266-1270.
6.	Huang C, Yu T, Zhang X. Doubly committed subarterial ventricular septal defects closure using minimal mid-partial sternotomy. Ann Thorac Cardiovasc Surg, 2019, 25(3): 172-175.
7.	de Leval MR, Pozzi M, Starnes V, et al. Surgical management of doubly committed subarterial ventricular septal defects. Circulation, 1988, 78(5 Pt 2): I40-I46.
8.	Zhang S, Zhu D, An Q, et al. Minimally invasive perventricular device closure of doubly committed sub-arterial ventricular septal defects: single center long-term follow-up results. J Cardiothorac Surg, 2015, 10: 119.
9.	Devlin PJ, Russell HM, Mongé MC, et al. Doubly committed and juxtaarterial ventricular septal defect: outcomes of the aortic and pulmonary valves. Ann Thorac Surg, 2014, 97(6): 2134-2140.
10.	Kwok SY, Yeung SS, Li VW, et al. Ventricular mechanics after repair of subarterial and perimembranous VSDs. Eur J Clin Invest, 2017, 47(12).
11.	Hornung M, Franke J, Id D, et al. Interventional closure of atrial septal defects, patent oval foramen and ventricular septal defects. Herz, 2015, 40(5): 765-770.
12.	Shyu TC, Lin MC, Quek YW, et al. Initial experience of transcatheter closure of subarterial VSD with the Amplatzer duct occluder. J Chin Med Assoc, 2017, 80(8): 487-491.
13.	Hu S, Yang Y, Wu Q, et al. Results of two different approaches to closure of subaortic ventricular septal defects in children. Eur J Cardiothorac Surg, 2014, 46(4): 648-653.
14.	Zhou D, Pan W, Guan L, et al. Transcatheter closure of perimembranous and intracristal ventricular septal defects with the SHSMA occluder. Catheter Cardiovasc Interv, 2012, 79(4): 666-674.
15.	Gu M, You X, Zhao X, et al. Transcatheter device closure of intracristal ventricular septal defects. Am J Cardiol, 2011, 107(1): 110-113.
16.	Zhou S, Zhao L, Fan T, et al. Perventricular device closure of doubly committed sub-arterial ventricular septal defects via a left infra-axillary approach. J Card Surg, 2017, 32(6): 382-386.
17.	Soto B, Becker AE, Moulaert AJ, et al. Classification of ventricular septal defects. Br Heart J, 1980, 43(3): 332-343.
18.	Liao Y, Long X, Zhu S, et al. Minimally access via left anterior mini-thoracotomy for repair of adult subarterial ventricular septal defects. J Cardiothorac Surg, 2017, 12(1): 48.
19.	Kanter RJ, Garson A Jr. Atrial arrhythmias during chronic follow-up of surgery for complex congenital heart disease. Pacing Clin Electrophysiol, 1997, 20(2 Pt 2): 502-511.
20.	Khairy P, Dore A, Talajic M, et al. Arrhythmias in adult congenital heart disease. Expert Rev Cardiovasc Ther, 2006, 4(1): 83-95.
21.	Rekawek J, Kansy A, Miszczak-Knecht M, et al. Risk factors for cardiac arrhythmias in children with congenital heart disease after surgical intervention in the early postoperative period. J Thorac Cardiovasc Surg, 2007, 133(4): 900-904.
22.	Laţcu DG, Bun SS, Viera F, et al. Selection of critical isthmus in scar-related atrial tachycardia using a new automated ultrahigh resolution mapping system. Circ Arrhythm Electrophysiol, 2017, 10(1): pii: e004510.
23.	Munnell ER, Grantham RN. Left ventricular decompression by sump drainage. Ann Thorac Surg, 1979, 28(4): 397-398.
24.	Heimbecker RO, McKenzie FN. A new approach to left heart decompression. Ann Thorac Surg, 1976, 21(5): 456-457.
25.	Booher AM, Bach DS. Acquired pulmonary vein stenosis: one problem, two mechanisms. J Am Soc Echocardiogr, 2010, 23(8): 904. e1-e3.

1. Cao H, Chen Q, Zhang GC, et al. Transthoracic subarterial ventricular septal defect occlusion using a minimally invasive incision. J Card Surg, 2016, 31(6): 398-402.
2. Waqar T, Rizvi MFA, Baig AR. Doubly committed subarterial ventricular septal defect repair: An experience of 51 cases. Pak J Med Sci, 2017, 33(5): 1112-1116.
3. Liu R, Rui L, Zhang B, et al. Through tricuspid closure for doubly committed subarterial ventricular septal defect with right vertical subaxillary mini-incision: a matched-pair analysis. Pediatr Cardiol, 2019, 40(6): 1247-1252.
4. Duong DH, Pham QD. Closure of subarterial ventricular septal defect with minimally invasive surgical technique: A case report. Int J Surg Case Rep, 2019, 58: 142-144.
5. Lun K, Li H, Leung MP, et al. Analysis of indications for surgical closure of subarterial ventricular septal defect without associated aortic cusp prolapse and aortic regurgitation. Am J Cardiol, 2001, 87(11): 1266-1270.
6. Huang C, Yu T, Zhang X. Doubly committed subarterial ventricular septal defects closure using minimal mid-partial sternotomy. Ann Thorac Cardiovasc Surg, 2019, 25(3): 172-175.
7. de Leval MR, Pozzi M, Starnes V, et al. Surgical management of doubly committed subarterial ventricular septal defects. Circulation, 1988, 78(5 Pt 2): I40-I46.
8. Zhang S, Zhu D, An Q, et al. Minimally invasive perventricular device closure of doubly committed sub-arterial ventricular septal defects: single center long-term follow-up results. J Cardiothorac Surg, 2015, 10: 119.
9. Devlin PJ, Russell HM, Mongé MC, et al. Doubly committed and juxtaarterial ventricular septal defect: outcomes of the aortic and pulmonary valves. Ann Thorac Surg, 2014, 97(6): 2134-2140.
10. Kwok SY, Yeung SS, Li VW, et al. Ventricular mechanics after repair of subarterial and perimembranous VSDs. Eur J Clin Invest, 2017, 47(12).
11. Hornung M, Franke J, Id D, et al. Interventional closure of atrial septal defects, patent oval foramen and ventricular septal defects. Herz, 2015, 40(5): 765-770.
12. Shyu TC, Lin MC, Quek YW, et al. Initial experience of transcatheter closure of subarterial VSD with the Amplatzer duct occluder. J Chin Med Assoc, 2017, 80(8): 487-491.
13. Hu S, Yang Y, Wu Q, et al. Results of two different approaches to closure of subaortic ventricular septal defects in children. Eur J Cardiothorac Surg, 2014, 46(4): 648-653.
14. Zhou D, Pan W, Guan L, et al. Transcatheter closure of perimembranous and intracristal ventricular septal defects with the SHSMA occluder. Catheter Cardiovasc Interv, 2012, 79(4): 666-674.
15. Gu M, You X, Zhao X, et al. Transcatheter device closure of intracristal ventricular septal defects. Am J Cardiol, 2011, 107(1): 110-113.
16. Zhou S, Zhao L, Fan T, et al. Perventricular device closure of doubly committed sub-arterial ventricular septal defects via a left infra-axillary approach. J Card Surg, 2017, 32(6): 382-386.
17. Soto B, Becker AE, Moulaert AJ, et al. Classification of ventricular septal defects. Br Heart J, 1980, 43(3): 332-343.
18. Liao Y, Long X, Zhu S, et al. Minimally access via left anterior mini-thoracotomy for repair of adult subarterial ventricular septal defects. J Cardiothorac Surg, 2017, 12(1): 48.
19. Kanter RJ, Garson A Jr. Atrial arrhythmias during chronic follow-up of surgery for complex congenital heart disease. Pacing Clin Electrophysiol, 1997, 20(2 Pt 2): 502-511.
20. Khairy P, Dore A, Talajic M, et al. Arrhythmias in adult congenital heart disease. Expert Rev Cardiovasc Ther, 2006, 4(1): 83-95.
21. Rekawek J, Kansy A, Miszczak-Knecht M, et al. Risk factors for cardiac arrhythmias in children with congenital heart disease after surgical intervention in the early postoperative period. J Thorac Cardiovasc Surg, 2007, 133(4): 900-904.
22. Laţcu DG, Bun SS, Viera F, et al. Selection of critical isthmus in scar-related atrial tachycardia using a new automated ultrahigh resolution mapping system. Circ Arrhythm Electrophysiol, 2017, 10(1): pii: e004510.
23. Munnell ER, Grantham RN. Left ventricular decompression by sump drainage. Ann Thorac Surg, 1979, 28(4): 397-398.
24. Heimbecker RO, McKenzie FN. A new approach to left heart decompression. Ann Thorac Surg, 1976, 21(5): 456-457.
25. Booher AM, Bach DS. Acquired pulmonary vein stenosis: one problem, two mechanisms. J Am Soc Echocardiogr, 2010, 23(8): 904. e1-e3.

Previous Article
加速康复外科的规范与安全
Next Article
Study on diagnosis and treatment of Budd-Chiari syndrome in China based on CO-word analysis

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Simple pulmonary artery approach in subarterial ventricular septal defect repair in 102 patients: A clinical analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content