Results
126 patients were successfully operated by an ultra-minimal trans intercostal device closure in all 131 cases. Operation success rate is 96.18%.
13 patients with PmVSD had aneurysm of membranous septum (AMS). Single stream PmVSDs, which with or without AMS, were found in 118 cases. Multistream (more than or equal to 2) PmVSDs with AMS were found in eleven cases. All of them were closed using one concentric occluder. There was a mild residual shunt with a diameter of 1.5 mm and a flowing velocity of 2.0 m/s beside the amplatzer occluder after the surgery, and it had self healed during the 5-month follow-up period. 9 cases of mild pericardial effusion was found after the operation and all disappeared during the 3-month follow-up period. Three cases had a trasient postoperative hyperpyrexia and returned to normal after treatment. The degree of TR did not aggravate after surgery. The patients with successful surgery had good cardiac function. No blood transfusions, serious arrhythmias or death occurred. Neither did dislocated devices, residual shunt or device-related valve regurgitation.
5 patients transferred to ventricular septal defect repair operation under direct visualization with a cardiopulmonary bypass, and the operations were smooth and the follow-up were normal. One patient was a fat kid of 63-kg-weight and129-month-old. The surgeon pulled on leftwards the heart more than 3cm to find the precise position of the purse-string suture. Ventricular fibrillation occured when guide wire passed the PmVSD. Another child patient was a 39-month-old and 15-kg-weight boy with large PmVSD of 7.7 mm size. The surgeon tried to close the large PmVSD with 8mm and 9mm large device, but the devices was translocated. The procedure was not performed again using larger device considering his age. Others were the guide wire cannot pass through the PmVSD, so the surgeons can only performed VSD repair under cardiopulmonary bypass.
All patients were followed for a perid ranging from18 months to 24 months. Follow-up examinations showed good placement of the occluder, good heart function, no residual shunts, no arrhythmia, no infective endocarditis and no thrombus. Device-related valve regurgitation were not found.