Perventricular device closure of doubly committed sub‐arterial ventricular septal defects via a left infra‐axillary approach
Background This study sought to evaluate the feasibility, safety, and efficacy of perventricular device closure of a doubly committed sub‐arterial ventricular septal defect (dcVSD) through a left infra‐axillary approach. Method Forty‐five patients, with a dcVSD of less than 8 mm in diameter, were en...
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Published in | Journal of cardiac surgery Vol. 32; no. 6; pp. 382 - 386 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
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United States
01.06.2017
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Abstract | Background
This study sought to evaluate the feasibility, safety, and efficacy of perventricular device closure of a doubly committed sub‐arterial ventricular septal defect (dcVSD) through a left infra‐axillary approach.
Method
Forty‐five patients, with a dcVSD of less than 8 mm in diameter, were enrolled in this study. The pericardium was exposed and opened through a left infra‐axillary mini‐incision. Two parallel purse‐string sutures were placed on the right ventricle outflow tract and under transesophageal echocardiography guidance, a delivery sheath loaded with the device was inserted into the right ventricle and advanced through the defect into the left ventricle. The device, connected to a delivery cable, was then deployed.
Results
Forty‐one patients achieved successful device closure. In four patients, the device failed to occlude the VSD due to device dislodgement, device‐related aortic regurgitation, and residual shunts, and open surgical repair was required. The mean dcVSD diameter was 4.5 ± 1.0 mm (range, 3.0‐8.0 mm). The implanted device size was 6.0 ± 1.5 mm (range, 4‐10 mm). All patients were implanted with an eccentric device. The mean intracardiac manipulation time was 20.9 ± 7.1 min (range, 9‐45 min). The procedure time was 62.5 ± 19.5 min (range 34‐105 min). There were no severe adverse events.
Conclusions
Perventricular device closure of a dcVSD through a left infra‐axillary approach is feasible, safe, and efficacious in selected patients with dcVSD. |
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AbstractList | BACKGROUNDThis study sought to evaluate the feasibility, safety, and efficacy of perventricular device closure of a doubly committed sub-arterial ventricular septal defect (dcVSD) through a left infra-axillary approach.METHODForty-five patients, with a dcVSD of less than 8 mm in diameter, were enrolled in this study. The pericardium was exposed and opened through a left infra-axillary mini-incision. Two parallel purse-string sutures were placed on the right ventricle outflow tract and under transesophageal echocardiography guidance, a delivery sheath loaded with the device was inserted into the right ventricle and advanced through the defect into the left ventricle. The device, connected to a delivery cable, was then deployed.RESULTSForty-one patients achieved successful device closure. In four patients, the device failed to occlude the VSD due to device dislodgement, device-related aortic regurgitation, and residual shunts, and open surgical repair was required. The mean dcVSD diameter was 4.5 ± 1.0 mm (range, 3.0-8.0 mm). The implanted device size was 6.0 ± 1.5 mm (range, 4-10 mm). All patients were implanted with an eccentric device. The mean intracardiac manipulation time was 20.9 ± 7.1 min (range, 9-45 min). The procedure time was 62.5 ± 19.5 min (range 34-105 min). There were no severe adverse events.CONCLUSIONSPerventricular device closure of a dcVSD through a left infra-axillary approach is feasible, safe, and efficacious in selected patients with dcVSD. This study sought to evaluate the feasibility, safety, and efficacy of perventricular device closure of a doubly committed sub-arterial ventricular septal defect (dcVSD) through a left infra-axillary approach. Forty-five patients, with a dcVSD of less than 8 mm in diameter, were enrolled in this study. The pericardium was exposed and opened through a left infra-axillary mini-incision. Two parallel purse-string sutures were placed on the right ventricle outflow tract and under transesophageal echocardiography guidance, a delivery sheath loaded with the device was inserted into the right ventricle and advanced through the defect into the left ventricle. The device, connected to a delivery cable, was then deployed. Forty-one patients achieved successful device closure. In four patients, the device failed to occlude the VSD due to device dislodgement, device-related aortic regurgitation, and residual shunts, and open surgical repair was required. The mean dcVSD diameter was 4.5 ± 1.0 mm (range, 3.0-8.0 mm). The implanted device size was 6.0 ± 1.5 mm (range, 4-10 mm). All patients were implanted with an eccentric device. The mean intracardiac manipulation time was 20.9 ± 7.1 min (range, 9-45 min). The procedure time was 62.5 ± 19.5 min (range 34-105 min). There were no severe adverse events. Perventricular device closure of a dcVSD through a left infra-axillary approach is feasible, safe, and efficacious in selected patients with dcVSD. Background This study sought to evaluate the feasibility, safety, and efficacy of perventricular device closure of a doubly committed sub‐arterial ventricular septal defect (dcVSD) through a left infra‐axillary approach. Method Forty‐five patients, with a dcVSD of less than 8 mm in diameter, were enrolled in this study. The pericardium was exposed and opened through a left infra‐axillary mini‐incision. Two parallel purse‐string sutures were placed on the right ventricle outflow tract and under transesophageal echocardiography guidance, a delivery sheath loaded with the device was inserted into the right ventricle and advanced through the defect into the left ventricle. The device, connected to a delivery cable, was then deployed. Results Forty‐one patients achieved successful device closure. In four patients, the device failed to occlude the VSD due to device dislodgement, device‐related aortic regurgitation, and residual shunts, and open surgical repair was required. The mean dcVSD diameter was 4.5 ± 1.0 mm (range, 3.0‐8.0 mm). The implanted device size was 6.0 ± 1.5 mm (range, 4‐10 mm). All patients were implanted with an eccentric device. The mean intracardiac manipulation time was 20.9 ± 7.1 min (range, 9‐45 min). The procedure time was 62.5 ± 19.5 min (range 34‐105 min). There were no severe adverse events. Conclusions Perventricular device closure of a dcVSD through a left infra‐axillary approach is feasible, safe, and efficacious in selected patients with dcVSD. |
Author | Dong, Haoju Li, Bin Zhou, Sijie Song, Shubo Fan, Taibing Zhao, Liyun Liang, Weijie Liu, Lin |
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Cites_doi | 10.1136/hrt.43.3.332 10.1016/S0735-1097(88)80023-8 10.1186/s13019-015-0376-9 10.1016/S0002-9149(01)01517-X 10.1016/0003-4975(90)90859-5 10.1016/0003-4975(92)91449-J 10.1111/jocs.12361 10.1186/s13019-015-0326-6 10.1053/j.pcsu.2006.02.020 10.1111/jocs.12134 |
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Keywords | left infra-axillary route cosmetic effect perventricular device closure device closure of dcVSD doubly committed subarterial ventricular septal defect |
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Pediatr Card Surg Annu doi: 10.1053/j.pcsu.2006.02.020 contributor: fullname: Tweddell – volume: 28 start-page: 456 year: 2013 ident: 10.1111/jocs.13155-BIB0010|jocs13155-cit-0010 article-title: Intraoperative device closure of subaortic ventricular septal defects publication-title: J Card Surg doi: 10.1111/jocs.12134 contributor: fullname: Liu |
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This study sought to evaluate the feasibility, safety, and efficacy of perventricular device closure of a doubly committed sub‐arterial ventricular... This study sought to evaluate the feasibility, safety, and efficacy of perventricular device closure of a doubly committed sub-arterial ventricular septal... BACKGROUNDThis study sought to evaluate the feasibility, safety, and efficacy of perventricular device closure of a doubly committed sub-arterial ventricular... |
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SubjectTerms | Cardiac Surgical Procedures - instrumentation Cardiac Surgical Procedures - methods Child, Preschool cosmetic effect device closure of dcVSD doubly committed subarterial ventricular septal defect Echocardiography, Transesophageal Female Follow-Up Studies Heart Septal Defects, Ventricular - diagnostic imaging Heart Septal Defects, Ventricular - surgery Humans Infant left infra‐axillary route Male perventricular device closure Septal Occluder Device Surgery, Computer-Assisted - instrumentation Surgery, Computer-Assisted - methods Treatment Outcome |
Title | Perventricular device closure of doubly committed sub‐arterial ventricular septal defects via a left infra‐axillary approach |
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