Shijun Hu1, Yifeng Yang1, Yun Zhu1, Qin Wu1, Rwakaryebe Muhoozi1, Shijie Wei1, Xiaojie Huang1, Tianli Zhao2. 1. Department of Cardiothoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, China. 2. Department of Cardiothoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, China dr.zhaotl@gmail.com.
Abstract
OBJECTIVES: 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.
OBJECTIVES: 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.