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.